Cytomegalovirus disease, haemophagocytic syndrome, immunosuppression in patients with IBD: 'A cocktail best avoided, not stirred'

Daniel van Langenberg, Graham Morrison, Anna Foley, Raymond Buttigieg, Peter Gibson

Research output: Contribution to journalArticleOther

17 Citations (Scopus)


We report two cases of cytomegalovirus (CMV) viraemia resulting in severe pneumonitis and associated haemophagocytic syndrome manifesting in patients with inflammatory bowel disease, on stable doses of azathioprine in clinical remission. In both cases, azathioprine was withdrawn at time of hospital presentation and after delays in diagnosis; intravenous ganciclovir was then administered, with resultant rapid improvement of haematological and clinical parameters. Following recovery, immunomodulators were not recommenced given patient aversion and the theoretical risk of CMV reactivation, albeit the evidence for this approach is limited. CMV-related haemophagocytic syndrome and organ dysfunction, in the context of immunomodulator therapy in IBD are rare but life-threatening, and thus requires further investigation and discussion.
Original languageEnglish
Pages (from-to)469 - 472
Number of pages4
JournalJournal of Crohn's and Colitis
Issue number5
Publication statusPublished - 2011

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