Korean J Gastroenterol.  2010 Jul;56(1):45-48. 10.4166/kjg.2010.56.1.45.

A Case of Hemophagocytic Syndrome in an Ulcerative Colitis Patient

• Kim YC
• Kim GM
• Lee HS
• Hong SI
• Cheung DY
• Kim JI
• Park SH
• Kim JK

• KMID: 1775878
• DOI: http://doi.org/10.4166/kjg.2010.56.1.45

Abstract

A case of hemophagocytic syndrome associated with ulcerative colitis is very rare. A 32-year-old man visited the hospital complaining of fever and severe abdominal pain for 7 days. He was diagnosed to have ulcerative colitis 2 years ago and had been treated with sulfasalazine. Three months ago, he had abdominal pain, weight loss, and hematochezia, so prednisolone and mercaptopurine were added to the treatment. On admission, the physical examination showed splenomegaly. Peripheral blood counts revealed pancytopenia, and bone marrow aspirate smears showed many histiocytes with active hemophagocytosis. There was no evidence of viral and bacterial infections and other neoplasms, which were commonly associated with hemophagocytic syndrome. He was successfully treated with high dose steroid. We report this case along with a review of the related literatures.

Keyword

Ulcerative colitis; Hemophagocytic syndrome

MeSH Terms

6-Mercaptopurine/therapeutic use
Adult
Anti-Inflammatory Agents/therapeutic use
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Bone Marrow Cells/pathology
Colitis, Ulcerative/complications/*diagnosis/drug therapy
Colonoscopy
Dexamethasone/therapeutic use
Humans
Immunosuppressive Agents/therapeutic use
Lymphohistiocytosis, Hemophagocytic/complications/*diagnosis/drug therapy
Male
Prednisolone/therapeutic use
Sulfasalazine/therapeutic use
Syndrome
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. Colonoscopic finding before treatment. It showed mucosal edema, ulcerations, and many inflammatory polyps consistent with severe ulcerative colitis.

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  Fig. 2. Bone marrow finding. Bone marrow aspiration revealed histiocytes with active hemophagocytosis (May-Grunwald Giemsa stain, ×400).

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  Fig. 3. Follow-up colonoscopic finding. It showed improved mucosal edema, ulceration, and inflammatory polyps of colon compared to previous colonoscopic findings.

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