A Case of Hemophagocytic Syndrome in an Ulcerative Colitis Patient

Yong Cheol Kim; Gun Min Kim; Ho Sang Lee; Seok In Hong; Dae Young Cheung; Jin Il Kim; Soo-Heon Park; Jae Kwang Kim

doi:10.4166/kjg.2010.56.1.45

Journal List > Korean J Gastroenterol > v.56(1) > 1006756

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Kim, Kim, Lee, Hong, Cheung, Kim, Park, and Kim: A Case of Hemophagocytic Syndrome in an Ulcerative Colitis Patient

Original Article

Korean J Gastroenterol 2010;56(1):45-48.

Published online: 21 February 2010

DOI: https://doi.org/10.4166/kjg.2010.56.1.45

A Case of Hemophagocytic Syndrome in an Ulcerative Colitis Patient

Yong Cheol Kim, M.D., Gun Min Kim, M.D., Ho Sang Lee, M.D., Seok In Hong, M.D., Dae Young Cheung, M.D., Jin Il Kim, M.D., Soo-Heon Park, M.D., Jae Kwang Kim, M.D.

Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea

Correspondence to: Jae Kwang Kim, M.D. Department of Internal Medicine, The Catholic University of Korea, College of Medicine, 62, Yeouido-dong, Yeongdeungpo- gu, Seoul 150-713, Korea Tel: +82-2-3779-2382, Fax: +82-2-3779-1331 E-mail: jkkim488@yahoo.co.kr

Received 9 December 2009 Accepted 16 March 2010

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.

Keywords: Ulcerative colitis, Hemophagocytic syndrome

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Fig. 1.

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

Fig. 2.

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

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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