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Symptomatic Exacerbation of Crohn Disease after Treatment with High-Dose Interleukin-2

Joseph A. Sparano, MD; Lawrence J. Brandt, MD; Janice P. Dutcher, MD; Jon S. Dubois, MD; and Michael B. Atkins, MD
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From Albert Einstein Cancer Center, Montefiore Medical Center, Bronx, New York; New England Medical Center, Boston, Massachusetts. Requests for Reprints: Joseph A. Sparano, MD, Albert Einstein Cancer Center, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467. Acknowledgments: The authors thank Dr. Panna Mahadevia who assisted in reviewing the pathologic material. Grant Support: In part by a grant from the National Institutes of Health (CA P30CA1130) and an American Cancer Society Career Development Award (JAS, 92-274).


Copyright 2004 by the American College of Physicians


Ann Intern Med. 1993;118(8):617-618. doi:10.7326/0003-4819-118-8-199304150-00007
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Two patients treated with high-dose interleukin-2 (IL-2), who had a history of Crohn disease that was clinically quiescent for 4 and 9 years before therapy, developed symptomatic reactivation of Crohn disease requiring surgical intervention. At laparotomy, both patients had histologic evidence of active Crohn disease. One patient had previously received another cytokine, -interferon-, without disease reactivation, suggesting that this effect was specific for IL-2. The striking temporal relation between the administration of IL-2 and the symptomatic reactivation of previously quiescent Crohn disease suggests the need to carefully evaluate patients with a history of inflammatory bowel disease who are considered for IL-2 therapy and provides evidence supporting an important role for IL-2 in the pathogenesis of Crohn disease.

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Figure 1.
Sigmoid colon.long arrowsshort open arrow

Photograph of the sigmoid colon showing a deep-fissure ulcer ( ) lined by granulation tissue ( ) (original magnification, 10).

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