JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE
Online ISSN : 1349-7421
Print ISSN : 0468-2513
ISSN-L : 0468-2513
CASE REPORTS
A Case of Crohn's Disease With Varicella-Zoster Virus Infection and Acute Liver Failure During Remission Maintenance With Infliximab and Azathioprine
Ken OKAWARA
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2025 Volume 73 Issue 5 Pages 453-460

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Abstract
 A 34-year-old man had been diagnosed with ileocolonic-type Crohn's disease at the age of 27 years. He had undergone a wait-and-see partial ileal resection and an ileocecal resection for an intestinal fistula, and clinical remission was maintained with the maximal dose of infliximab and azathioprine. The patient developed a sore throat, fever, and rash that spread from the face to the rest of the body, and he was admitted to the hospital with liver dysfunction. Varicellazoster virus infection was found, and acute liver failure developed due to a rapid decrease in hepatic reserve. Visceral disseminated varicella-zoster virus infection was strongly suspected. After antiviral therapy and steroid pulse therapy, the liver failure became mild and the patient was discharged from the hospital. It should be noted that fatal infections can occur in patients with inflammatory bowel disease on immunosuppressive drugs.
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