Maaherra Ragnar Lassinantti 26/1 1975

Kirje 26.1.1975

Fatal case of Epstein-Barr virus primo-infection, haemophagocytic syndrome in a 26-year-old patient treated with azathioprine for Crohn's disease: an autopsy case

Objective: A 26-year-old man with a history of Crohn's disease, treated with azathioprine since 2 years, presented an Epstein-Barr virus (EBV) primo-infection and exacerbation of digestive symptoms. Method: An ileo-colectomy was performed, which showed a fatal EBV lymphoproliferation disorder along with a haemophagocytic syndrome. EBV DNA load in the peripheral blood persisted to be high loaded during hospitalisation (479,000 copies per milliliter) despite triple antiviral treatment. Results: Autopsy revealed a systemic lymphoproliferation involving lymph nodes, gastrointestinal mucosa and solid viscera (heart, kidney, lungs, prostate, brain). This was compounded of a population of large polymorphic B cell, hypertrophic macrophages and T lymphocytes, associated to haemophagocytosis. These massive infiltrations mimicked macroscopically as ulcers in the intestinal mucosa and ranged from polymorphic with plasmocytic differentiation to monomorphic large cells. Autopsy results confirmed the absence of Crohn's disease reactivation. The EBV infection was observed in all organs within the large images of the B cell lymphoproliferations. Further postmortem investigations revealed a deficit of the azathioprine's metabolisation enzyme thiopurine methyltransferase (TPMT). Conclusion: We report and discuss herein the observations of a complete autopsy case along with the postmortem identification of the EBV infection type and TPMT mutation in a patient treated by azathioprine for Crohn's disease. Autopsy findings and further investigations helped explain the complicate clinical evolution and the fatal issue of the patient.

Tasavallan Presidentti Urho Kekkosen vierailu Romaniaan 22.-26.9.1969 (Tasavallan Presidentin Romaniaan saapumispuhe 22.9.1969)

Puhe

Kajaanissa 16/5 -26

Kirje 16.5.1926

Unmet Needs SFY 2005 Final Report Version 2 10/26/2005

Despite the successes of the Senior Living Program and other efforts of the Iowa Aging Network, there continue to be documented unmet needs throughout the state, in part because of general fund budget reductions. These are needs identified for elderly Iowans that the community service networks are unable to meet. The sources for this data are interdisciplinary teams with the Case Management Program for the Frail Elderly (CMPFE) and service providers under contract with the Area Agencies on Aging.

Vuorineuvos Erik Serlachius 26/12 1958

Kirje

Direktör Pekka Martin 26.2.1973 Tippningsbolaget

Kirje

ABD e-News, October 26, 2007

Weekly Newsletter

Motor Vehicle Accident Fatalities for the Week Ending, October 26, 2007

Record of the Fatalities for Motor Vehicle Accidents in Iowa per week.

EPI Update, October 26, 2007

Weekly newsletter for Center For Acute Disease Epidemiology of Iowa Department of Public Health.