Reversible Lymphoma in the Setting of Azathioprine Therapy for Crohn's Disease

To the Editor: The use of immunosuppressive agents after organ transplantation is associated with an increased risk of lymphoproliferative disorders related to Epstein-Barr virus (EBV) 1 . The risk of these disorders with immunosuppressive therapy for other conditions, such as inflammatory bowel disease, is not well established. We describe a patient in whom a reversible EBV-related lymphoproliferative disease developed during treatment with azathioprine for Crohn's disease. A 33-year-old man had a 13-year history of Crohn's disease involving the whole small bowel. Because the disease was steroid-dependent, azathioprine therapy was started (100 mg per day) in April 1988. After steroids were withdrawn, . . .