Literature DB >> 29356833

[Severe lymphopenia in a patient with Crohn's disease].

C Monasterio1, W Kreisel2, P Hasselblatt2.   

Abstract

We report on a 25-year-old female patient with Crohn's disease and profound lymphocytopenia while receiving corticosteroids and azathioprine. Discontinuation of azathioprine only resulted in a mild increase in CD4+ T cell numbers; however, therapy with the TNFα inhibitor adalimumab was initiated for a clinical flare and resulted in long-lasting clinical remission and rapid normalization of the lymphocytopenia including the respective lymphocyte subsets. Lymphocytopenia is frequently observed as a side effect of immunosuppressive therapy. This case illustrates that lymphocytopenia may also occur in relation to Crohn's disease activity as an extraintestinal manifestation and may then be efficiently treated by escalation of immunosuppressive therapy.

Entities:  

Keywords:  Adalimumab; Azathioprine; Extraintestinal manifestations; Immunosuppression; Tumor necrosis factor α

Mesh:

Substances:

Year:  2018        PMID: 29356833     DOI: 10.1007/s00108-017-0363-4

Source DB:  PubMed          Journal:  Internist (Berl)        ISSN: 0020-9554            Impact factor:   0.743


  9 in total

1.  Lymph loss in the bowel and severe nutritional disturbances in Crohn's disease.

Authors:  D Baert; D Wulfrank; P Burvenich; J Lagae
Journal:  J Clin Gastroenterol       Date:  1999-10       Impact factor: 3.062

Review 2.  Review article: non-malignant haematological complications of anti-tumour necrosis factor alpha therapy.

Authors:  T Bessissow; M Renard; I Hoffman; S Vermeire; P Rutgeerts; G Van Assche
Journal:  Aliment Pharmacol Ther       Date:  2012-06-24       Impact factor: 8.171

3.  Relationship between azathioprine dosage, 6-thioguanine nucleotide levels, and therapeutic response in pediatric patients with IBD treated with azathioprine.

Authors:  Mi-Na Lee; Ben Kang; So Yoon Choi; Mi Jin Kim; Sook Young Woo; Jong-Won Kim; Yon Ho Choe; Soo-Youn Lee
Journal:  Inflamm Bowel Dis       Date:  2015-05       Impact factor: 5.325

4.  Adalimumab reversed a severe lymphopenia in a patient with Crohn's disease.

Authors:  Carlos Taxonera; Juan Luís Mendoza; Luís Ortega; María Inmaculada Pérez; Manuel Díaz-Rubio
Journal:  J Crohns Colitis       Date:  2011-12-14       Impact factor: 9.071

5.  Does lymphopenia or macrocytosis reflect 6-thioguanine levels in patients with inflammatory bowel disease treated with azathioprine or 6-mercaptopurine?

Authors:  N M Heerasing; J F Ng; D Dowling
Journal:  Intern Med J       Date:  2016-04       Impact factor: 2.048

6.  Serious infections and mortality in association with therapies for Crohn's disease: TREAT registry.

Authors:  Gary R Lichtenstein; Brian G Feagan; Russell D Cohen; Bruce A Salzberg; Robert H Diamond; Donny M Chen; Michelle L Pritchard; William J Sandborn
Journal:  Clin Gastroenterol Hepatol       Date:  2006-05       Impact factor: 11.382

Review 7.  Risk of infections associated with biological treatment in inflammatory bowel disease.

Authors:  Nynne Nyboe Andersen; Tine Jess
Journal:  World J Gastroenterol       Date:  2014-11-21       Impact factor: 5.742

8.  Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study.

Authors:  Laurent Beaugerie; Nicole Brousse; Anne Marie Bouvier; Jean Frédéric Colombel; Marc Lémann; Jacques Cosnes; Xavier Hébuterne; Antoine Cortot; Yoram Bouhnik; Jean Pierre Gendre; Tabassome Simon; Marc Maynadié; Olivier Hermine; Jean Faivre; Fabrice Carrat
Journal:  Lancet       Date:  2009-11-07       Impact factor: 79.321

9.  The Impact of Azathioprine-Associated Lymphopenia on the Onset of Opportunistic Infections in Patients with Inflammatory Bowel Disease.

Authors:  Marius Vögelin; Luc Biedermann; Pascal Frei; Stephan R Vavricka; Sylvie Scharl; Jonas Zeitz; Michael C Sulz; Michael Fried; Gerhard Rogler; Michael Scharl
Journal:  PLoS One       Date:  2016-05-23       Impact factor: 3.240

  9 in total

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