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An event is serious (based on the ICH definition) when the patient outcome is:
* congenital anomaly
* other medically important event
A 36-year-old woman developed classic Hodgkin's lymphoma following treatment with azathioprine and etrolizumab for ulcerative colitis [routes, dosages and duration of treatments to reaction onset not stated].
The woman, who was diagnosed with ulcerative colitis in 2009, started receiving treatment with azathioprine and etrolizumab. In 2015, she underwent subtotal colectomy due to perforation complication. In 2016, the rectal stump was received. Microscopic evaluation revealed a complete destructuration of the rectal wall with multiple pseudonodules. The pseudonodules were consisted of large mixed inflammatory cellularity (abundant eosinophils, plasmids and lymphocytes) along with abundant que atypical Stembergoid-type cells (CD30, CD15 and EMA positive). In situ hybridisation was positive for concurrent Epstein-Barr virus infection. She was diagnosed with classic Hodgkin's lymphoma associated with Epstein-Barr virus in the context of chronic ulcerative colitis [outcome not stated].
Author comment: "Several risk factors have been demonstrated for the development of lymphoproliferative syndromes associated with inflammatory bowel disease: Long-term chronic inflammation; infection of EBV and treatment with drugs modifying the immune response (especially in the combined use of thiopurines and biological agents)." "Reviews in the literature suggest an association with inflammatory bowel disease plus treatment immunosuppression that may lead to its treatment."
- Torrecilla Idoipe N, et al. Colorectal Hodgkin lymphoma in a patient with ulcerative colitis. Virchows Archiv: an international journal of pathology 473 (Suppl. 1): s176 abstr. PS-20-072, Sep 2018. Available from: URL: http://doi.org/10.1007/s00428-018-2422-1 [abstract] - Spain