Hemophagocytic Syndrome Caused by Fulminant Ulcerative Colitis and Cytomegalovirus Infection: Report of a Case

Authors:
  • TWToshiaki Watanabe
    Toshiaki Watanabe
  • NHNobukazu Hori
    Nobukazu Hori
  • NUNaoyuki Umetani
    Naoyuki Umetani
  • YTYutaka Takazawa
    Yutaka Takazawa
  • HNHirokazu Nagawa
    Hirokazu Nagawa
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Abstract
We report a case of hemophagocytic syndrome that developed in a 35-year-old, Japanese male with fulminant ulcerative colitis. The patient underwent an emergency operation, consisting of subtotal colectomy, ileostomy with rectal preservation (suprapubic mucous fistula). After the operation, peripheral blood counts showed progressive pancytopenia and bone marrow aspirate smears revealed hypocellular bone marrow with an increase in histiocytes, indicating hemophagocytic syndrome. Viral studies (serum antibody titer and antigenemia of cytomegalovirus) revealed systemic cytomegalovirus infection. The patient was diagnosed with virus-associated hemophagocytic syndrome and was successfully treated with antiviral therapy consisting of intravenous ganciclovir, gamma globulin, and granulocyte-colony stimulating factor.