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Case Report
 
Immunosuppression and infectious complications: A hemorrhagic dilemma
Isabelle Malhamé1, Amanda Farag2, Zu-hua Gao3, Alan Barkun2,4
1MD, Department of Internal Medicine, McGill University Health Center
2MD, Division of Gastroenterology, McGill University Health Center
3MD, Department of Pathology, McGill University Health Center
4MD, Clinical Epidemiology, McGill University Health Center

Article ID: Z01201708CR10818IM
doi:10.5348/ijcri-201779-CR-10818

Address correspondence to:
Alan Barkun
1001 Decarie Blvd
Montreal, QC
Canada H4A 3J1

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How to cite this article
Malhamé I, Farag A, Gao Z, Barkun A. Immunosuppression and infectious complications: A hemorrhagic dilemma. Int J Case Rep Images 2017;8(8):541–544.


ABSTRACT

Introduction: Patients treated with immunosuppressive agents for autoimmune diseases are a unique patient population. Simultaneous management of an underlying autoimmune disease and of an opportunistic infection can present a therapeutic dilemma.
Case Report: A 68-year-old female presented with signs and symptoms of vasculitis involving the gastrointestinal tract. After initiation of immunosuppressive treatment, she developed an infectious complication that led to intractable gastrointestinal bleeding.
Conclusion: Current recommendations addressing the management of cytomegalovirus infection in the context of a severe vasculitis are lacking, and our approach to this case may benefit physicians dealing with this clinical dilemma in the future.

Keywords: Cytomegalovirus, Immunosuppression, Vasculitis



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Author Contributions
Isabelle Malhamé – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Amanda Farag – Substantial contribution to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Zu-hua Gao – Substantial contribution to acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Alan Barkun – Substantial contribution to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Isabelle Malhamé et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.