Aspiration pneumonia and delayed perforation caused disseminated intravascular coagulation and death in the affected patients. Three patients with stage IV cancer died from progression (metastasis)

of advanced stage cancer of other organs within 6 months, and 12 patients remain alive over a follow-up period of 23.6 ± 17.1 months. Conclusion: Patients with advanced stage cancer of other organs are at high risk for poor prognosis due to complications related to ESD for EGC. Key Word(s): 1. Endoscopic submucosal dissection Presenting Author: ANDREW BUCKLE Additional Authors: WILLIAM TAM, MARK SCHOEMAN, JOHN ARGYRIDES Corresponding Author: ANDREW BUCKLE Affiliations: Royal Adelaide Hospital, Royal Adelaide Hospital, Royal Adelaide Hospital Objective: The thiopurines azathioprine (aza) and 6-mercaptopurine (6-MP) have been a mainstay of inflammatory Selleckchem H 89 bowel disease treatment for over 20 years. Cytomegalovirus (CMV) infection has long been associated

with IBD and suggested an aetiological factor in steroid-resistant colonic disease. Despite extensive experience with thiopurine therapy it is unclear if these medications predispose to CMV infection/reactivation. Methods: We present 4 case reports of patients with CMV viraemia of varying clinical severity whilst on thiopurine therapy. Results: Case 1 is a 28 year old male with Torin 1 research buy UC on 5-MP who presented with a febrile illness with pancytopaenia and a CMV viral load of 380000 copies. Case 2 is a 55 year old woman with a 4 year history of Crohn’s disease on aza who presented with a febrile illness following contact with a work colleague with confirmed CMV infection. Her CMV titre on admission was 880 000 copies. Case 3 is of a 44 year old female with ulcerative colitis controlled on 6-MP. She presented with a febrile illness, neutropaenia, deranged

LFTs, and a CMV titre of 63 000. In all cases prompt therapy with ganciclovir resulted in complete recovery. Case 4 is of a fatal CMV infection in a 57 year old female with a 5 year history of Crohn’s disease on 6-MP for 3 years. She presented with a febrile illness and macular rash, with bloods revealing neutropaenia, deranged LFTs, and acute kidney injury. Her else CMV titre was 85 000 copies. Unfortunately despite early ganciclovir therapy her condition continued to decline requiring respiratory and inotropic support and she died shortly thereafter. Conclusion: We present 4 case reports of CMV viraemia whilst receiving thiopurine therapy for IBD, highlighting the need for early consideration of CMV infection/reactivation in any patient in this population presenting with febrile illness and neutropaenia. Key Word(s): 1. Thiopurines; 2. azathioprine; 3. mercaptopurine; 4. Aza; 5. 6-Mp; 6. ulcerative colitis; 7. Crohn’s disease; cytomegalovirus Presenting Author: SOO-CHEON CHAE Additional Authors: J. MO, K. ALAM, S.