Epstein‐Barr virus‐associated lymphoma in Crohn's disease

Although no increased risk of developing lymphoproliferative disorders has been observed in population‐based studies of patients with Crohn's disease, the possibility has been suggested in the subset of patients previously treated with thiopurine metabolites and suffering from concomitant Epste...

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Bibliographic Details
Published in:Inflammatory bowel diseases 2004-07, Vol.10 (4), p.425-429
Main Authors: MD, Alessandra Losco, Gianelli, Umberto, Cassani, Barbara, Baldini, Luca, MD, Dario Conte, Basilisco, Guido
Format: Article
Language:English
Subjects:
Adult
Antibodies, Monoclonal - adverse effects
Azathioprine - adverse effects
Crohn Disease - complications
Crohn Disease - drug therapy
DNA, Viral - analysis
Epstein-Barr virus
Epstein-Barr Virus Infections - complications
Gastrointestinal Agents - adverse effects
Herpesvirus 4, Human - genetics
Herpesvirus 4, Human - pathogenicity
Humans
Ileal Neoplasms - etiology
Ileal Neoplasms - virology
Immunosuppressive Agents - adverse effects
Infliximab
Lymphoma, B-Cell - etiology
Lymphoma, B-Cell - virology
Male
Polymerase Chain Reaction
Tumor Necrosis Factor-alpha
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Summary:Although no increased risk of developing lymphoproliferative disorders has been observed in population‐based studies of patients with Crohn's disease, the possibility has been suggested in the subset of patients previously treated with thiopurine metabolites and suffering from concomitant Epstein–Barr virus infection. A few cases of lymphomas have occurred in patients with Crohn's disease treated with infliximab, only one of whom showed the presence of the Epstein‐Barr virus genome. We here describe the case of a patient with steroid‐dependent ileal Crohn's disease treated with azathioprine and a single infusion of infliximab, who developed a diffuse large B cell ileal lymphoma. Epstein‐Barr virus genome was detected in the neoplastic cells by means of polymerase chain reaction. Epstein‐Barr virus may be detected in the neoplastic tissues of lymphomas of patients with Crohn's disease treated with immunosuppressants and infliximab. The identification of such cases may help to define the frequency of this association and how to manage the lymphoproliferative disorder.
ISSN:1078-0998
1536-4844
DOI:10.1097/00054725-200407000-00015