Severe Complication of Thiopurine Treatment in a Young Woman with Crohn's Disease

Mpj Voet; Tga Calon; Mmc Hendriks; R M Schreuder

doi:10.12890/2021_002350

Severe Complication of Thiopurine Treatment in a Young Woman with Crohn's Disease

Eur J Case Rep Intern Med. 2021 Mar 29;8(3):002350. doi: 10.12890/2021_002350. eCollection 2021.

Authors

Mpj Voet¹, Tga Calon¹, Mmc Hendriks¹, R M Schreuder²

Affiliations

¹ Department of Internal Medicine, Catharina Ziekenhuis, Eindhoven, The Netherlands.
² Department of Gastroenterology and Hepatology, Catharina Ziekenhuis, Eindhoven, The Netherlands.

Abstract

Case description: A 28-year old woman receiving thiopurine treatment for Crohn's disease presented with a systemic primo cytomegalovirus (CMV) infection affecting the gut (colitis), liver (hepatitis), lungs (pneumonitis) and eyes (retinitis). Secondary to this systemic infection, she developed splenomegaly, pancytopenia and lymphadenopathy. Anti-viral treatment resulted in complete resolution of clinical, biochemical and radiological abnormalities within 6 weeks.

Conclusion: Early recognition is crucial since CMV infection in a patient receiving thiopurine treatment may result in serious complications.

Learning points: Cytomegalovirus (CMV) infection in patients receiving thiopurine treatment may result in serious complications.This case report describes extensive primo CMV infection causing colitis, hepatitis, pneumonitis and retinitis in a patient receiving thiopurine treatment.Early recognition and treatment of the infection is crucial.

Keywords: Cytomegalovirus; colitis; hepatitis; pneumonitis; thiopurine.