A case of EBV driven haemophagocytic lymphohistiocytosis complicating a teenage Crohn's disease patient on azathioprine, successfully treated with rituximab.
We report a case of Epstein-Barr virus infection with the subsequent development of haemophagocytic lymphohistiocytosis in a teenage Crohn's disease patient treated with azathioprine. We found that the early introduction of the anti-B cell monoclonal antibody rituximab precipitated a rapid fall in circulating B-cells and EBV viral load, resulting in a prompt and sustained recovery from what is a potentially fatal complication of azathioprine therapy in Crohn's disease patients.
Department of Paediatric Gastroenterology, Yorkhill Hospital, Glasgow, UK.
Michael P
MP
Fitzgerald
Lawrence
L
Armstrong
Rosie
R
Hague
Richard K
RK
Russell
D000293:Adolescent; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D001379:Azathioprine / Q000009:adverse effects* / Q000627:therapeutic use; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D000069283:Rituximab
D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab; D001379:Azathioprine