01 January 2005
Fulminant Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD) with concurrent cytomegalovirus infection following matched unrelated bone marrow transplantation
Ewa Lech-Marańda, Agnieszka Wierzbowska, Agata Wrzesień-Kuś, Halina Urbańska-Ryś, Jerzy Hołowiecki, Beata Hołowiecka, Sebastian Giebel, Jacek Bartkowiak, Andrzej Bednarek, Radzisław Kordek, Tadeusz RobakCase Rep Clin Pract Rev 2005; 6:196-199 :: ID: 428475
Abstract
Background: Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD) is a severe complication following allogeneic bone marrow transplantation (allo-BMT). It has been recently reported that cytomegalovirus (CMV) infection might have a contributory role in the development of
EBV-LPD.
Case report: A 39-year-old female patient in first chronic phase of chronic myelogenous leukaemia (CML, Ph+) received an allo-BMT from a matched unrelated donor. The transplant was unmanipulated. On day +47 after transplantation the patient was admitted to the hospital with fever of unknown origin and icterus. Clinical, laboratory and sonographic evaluation revealed increased WBC level, increased renal and liver parameters, enlargement of lymph nodes in the hilus of liver, and hepatosplenomegaly. A bone marrow biopsy showed 70% of infiltration by lymphoplasmocytoid cells. The pp-65 CMV antigen as well as CMV-DNA and EBV-DNA by PCR analysis were detected. On day + 49 the infusion of 375/m2 rituximab was applied. Despite the treatment, the renal and liver insufficiency had progressed, and on day +51 the patient died in multiorgan failure. The
histological postmortem examination demonstrated diffuse organ infiltration by monoclonal B-cells expressing EBV-LPD. Analysis of immunoglobulin heavy chain gene (IgH) rearrangement revealed monoclonality.
Conclusions: The final diagnosis, therefore, was the fulminant EBV-LPD with the concurrent CMV reactivation. CMV and EBV infection may develop simultaneously as a result of a deficient T-cell response after allo-BMT.
Keywords: Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD), Epstein-Barr virus, allogeneic bone marrow transplantation
3
In Press
12 Feb 2024 : Case report
Diagnostic Challenges and Imaging Considerations for Intraparotid Facial Nerve Schwannoma: A Case Report an...Am J Case Rep In Press; DOI: 10.12659/AJCR.942870
12 Feb 2024 : Case report
Erdheim-Chester Disease Occult on Radiographs and CT but Visible on MRI and PETAm J Case Rep In Press; DOI: 10.12659/AJCR.941169
12 Feb 2024 : Case report
Surgical Treatment of Spontaneous Superficial Temporal Artery Arteriovenous Malformation: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.942839
13 Feb 2024 : Case report
Warfarin Woes: A Rare Case of Hemoperitoneum with Intramural Small Bowel HematomaAm J Case Rep In Press; DOI: 10.12659/AJCR.943519
Most Viewed Current Articles
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
05 Mar 2022 : Case report
Acute Limb Ischemia After Self-Injection of Crushed Morphine Tablets into the Radial Artery: Role of Infrar...DOI :10.12659/AJCR.935336
Am J Case Rep 2022; 23:e935336
02 Apr 2022 : Case report
Infective Endocarditis Caused by Pseudomonas luteola in a Pediatric Patient. A Case Report and Review of Li...DOI :10.12659/AJCR.935743
Am J Case Rep 2022; 23:e935743