Fatal Epstein-Barr Virus Reactivation in an Acquired Aplastic Anemia Patient Treated with Rabbit Antithymocyte Globulin and Cyclosporine A
Epstein-Barr virus (EBV) associated lymphoproliferative disorder (LPD) after immunosuppressive therapy for aplastic anemia (AA) is extremely rare in a nontransplant setting and has not been well described. This report describes a severe AA patient in whom fatal EBV-LPD developed after being treated...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2015/926874 |
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| author | Tohru Takahashi Yumiko Maruyama Mayuko Saitoh Hideto Itoh Mitsuru Yoshimoto Masayuki Tsujisaki |
| author_facet | Tohru Takahashi Yumiko Maruyama Mayuko Saitoh Hideto Itoh Mitsuru Yoshimoto Masayuki Tsujisaki |
| author_sort | Tohru Takahashi |
| collection | DOAJ |
| description | Epstein-Barr virus (EBV) associated lymphoproliferative disorder (LPD) after immunosuppressive therapy for aplastic anemia (AA) is extremely rare in a nontransplant setting and has not been well described. This report describes a severe AA patient in whom fatal EBV-LPD developed after being treated with rabbit antithymocyte globulins (ATG) and cyclosporine A (CsA). An 81-year-old man was diagnosed as having severe AA. He was started on CsA followed by administration of ATG for five consecutive days. One month after the start of ATG, persistent fever which was not responsive to antibiotics or antifungal agents developed and atypical lymphocytes emerged in peripheral blood. Repeated blood cultures were negative. An extremely high level of EBV virus in his peripheral blood plasma was detected by means of a quantitative real-time PCR assay. Even after the cessation of CsA, the fever persisted and the peripheral atypical lymphocytes proliferated rapidly. The patient suffered from respiratory failure, liver dysfunction, and metabolic acidosis. Rituximab was administered without success and he died. |
| format | Article |
| id | doaj-art-ce3a477492504c399f9d284f82cf1f46 |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-ce3a477492504c399f9d284f82cf1f462025-02-03T01:00:36ZengWileyCase Reports in Hematology2090-65602090-65792015-01-01201510.1155/2015/926874926874Fatal Epstein-Barr Virus Reactivation in an Acquired Aplastic Anemia Patient Treated with Rabbit Antithymocyte Globulin and Cyclosporine ATohru Takahashi0Yumiko Maruyama1Mayuko Saitoh2Hideto Itoh3Mitsuru Yoshimoto4Masayuki Tsujisaki5Department of Hematology, Tenshi Hospital, Kita-12, Higashi-3-1-1, Higashi-ku, Sapporo 065-0012, JapanDepartment of Hematology, Tenshi Hospital, Kita-12, Higashi-3-1-1, Higashi-ku, Sapporo 065-0012, JapanDepartment of Gastroenterology, Tenshi Hospital, Kita-12, Higashi-3-1-1, Higashi-ku, Sapporo 065-0012, JapanDepartment of Gastroenterology, Tenshi Hospital, Kita-12, Higashi-3-1-1, Higashi-ku, Sapporo 065-0012, JapanDepartment of Gastroenterology, Tenshi Hospital, Kita-12, Higashi-3-1-1, Higashi-ku, Sapporo 065-0012, JapanDepartment of Gastroenterology, Tenshi Hospital, Kita-12, Higashi-3-1-1, Higashi-ku, Sapporo 065-0012, JapanEpstein-Barr virus (EBV) associated lymphoproliferative disorder (LPD) after immunosuppressive therapy for aplastic anemia (AA) is extremely rare in a nontransplant setting and has not been well described. This report describes a severe AA patient in whom fatal EBV-LPD developed after being treated with rabbit antithymocyte globulins (ATG) and cyclosporine A (CsA). An 81-year-old man was diagnosed as having severe AA. He was started on CsA followed by administration of ATG for five consecutive days. One month after the start of ATG, persistent fever which was not responsive to antibiotics or antifungal agents developed and atypical lymphocytes emerged in peripheral blood. Repeated blood cultures were negative. An extremely high level of EBV virus in his peripheral blood plasma was detected by means of a quantitative real-time PCR assay. Even after the cessation of CsA, the fever persisted and the peripheral atypical lymphocytes proliferated rapidly. The patient suffered from respiratory failure, liver dysfunction, and metabolic acidosis. Rituximab was administered without success and he died.http://dx.doi.org/10.1155/2015/926874 |
| spellingShingle | Tohru Takahashi Yumiko Maruyama Mayuko Saitoh Hideto Itoh Mitsuru Yoshimoto Masayuki Tsujisaki Fatal Epstein-Barr Virus Reactivation in an Acquired Aplastic Anemia Patient Treated with Rabbit Antithymocyte Globulin and Cyclosporine A Case Reports in Hematology |
| title | Fatal Epstein-Barr Virus Reactivation in an Acquired Aplastic Anemia Patient Treated with Rabbit Antithymocyte Globulin and Cyclosporine A |
| title_full | Fatal Epstein-Barr Virus Reactivation in an Acquired Aplastic Anemia Patient Treated with Rabbit Antithymocyte Globulin and Cyclosporine A |
| title_fullStr | Fatal Epstein-Barr Virus Reactivation in an Acquired Aplastic Anemia Patient Treated with Rabbit Antithymocyte Globulin and Cyclosporine A |
| title_full_unstemmed | Fatal Epstein-Barr Virus Reactivation in an Acquired Aplastic Anemia Patient Treated with Rabbit Antithymocyte Globulin and Cyclosporine A |
| title_short | Fatal Epstein-Barr Virus Reactivation in an Acquired Aplastic Anemia Patient Treated with Rabbit Antithymocyte Globulin and Cyclosporine A |
| title_sort | fatal epstein barr virus reactivation in an acquired aplastic anemia patient treated with rabbit antithymocyte globulin and cyclosporine a |
| url | http://dx.doi.org/10.1155/2015/926874 |
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