Disseminated Intravascular Coagulation Associated With Systemic Cytomegalovirus Infection During Cyclosporine Therapy for Ulcerative Colitis: Report of a Case

The Use of Infliximab for Treatment of Hospitalized Patients with Acute Severe Ulcerative Colitis

“…To date, the only other acceptable rescue therapy for patients with UC refractory to IV steroids is cyclosporine. At many centres in North America, this therapy has fallen out of favour because of its serious adverse event profile (8)(9)(10)(11)(12)(13)(14)(15)(16)(17), poor long-term efficacy (11,(18)(19)(20)(21)(22) and the intense clinical and biochemical monitoring required while patients are taking this medication. Although there are no direct comparisons with cyclosporine, the safety profile of infliximab appears to be superior to that of cyclosporine (4).…”

Disseminated intravascular coagulation associated with cytomegalovirus infection in a patient with hepatitis C virus cirrhosis

“…There have been only a few reported cases of severe blood coagulation disorders occurring during human cytomegalovirus (CMV) infection and most of them involved immunosuppressed patients 1–5 . Cirrhotic patients suffer various grades of immunosuppression 6 and are at risk for CMV infection, which has been considered to be mild and asymptomatic 7 .…”

“…Experimental evidence suggests that CMV can infect endothelial cells causing coagulation abnormalities compatible with DIC 9 . In humans, CMV infection leading to DIC has been reported in association with immunocompromised conditions, 1–3 and has been reported twice in apparently immunocompetent patients 4,5 . The dysregulation of cellular immunity may induce a state of immunosuppression in cirrhotic patients, 6 which predisposes to CMV reactivation.…”

“…Dear Editor, There have been only a few reported cases of severe blood coagulation disorders occurring during human cytomegalovirus (CMV) infection and most of them involved immunosuppressed patients. [1][2][3][4][5] Cirrhotic patients suffer various grades of immunosuppression 6 and are at risk for CMV infection, which has been considered to be mild and asymptomatic. 7 We report on a patient with hepatitis C virus (HCV)-related cirrhosis and cryoglobulinemia, who developed overt disseminated intravascular coagulation (DIC) following acute CMV infection.…”