Epstein-Barr virus reactivation induced myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA)-associated vasculitis
| Autor: | Timothy Philip Noonan, Leonor Echevarria, Konstantin N. Konstantinov |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Epstein-Barr Virus Infections Herpesvirus 4 Human medicine.diagnostic_test business.industry Autoantibody Lymph node biopsy Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Valganciclovir General Medicine medicine.disease Lymphoid hyperplasia Antibodies Antineutrophil Cytoplasmic hemic and lymphatic diseases Immunology medicine Humans Eosinophilia medicine.symptom business Vasculitis Viral load Peroxidase medicine.drug Anti-neutrophil cytoplasmic antibody |
| Zdroj: | BMJ Case Reports. 14:e245059 |
| ISSN: | 1757-790X |
| DOI: | 10.1136/bcr-2021-245059 |
| Popis: | We present a patient with systemic symptoms including 4 months of dyspnoea worsened with exertion, fatigue, rhinorrhoea, intermittent facial swelling, generalised lymphadenopathy and weight loss. Laboratory studies demonstrated proteinuria and eosinophilia. His serology was consistent with Epstein-Barr Virus (EBV) reactivation. A lymph node biopsy was consistent with EBV-associated reactive lymphoid hyperplasia. He was told to continue symptomatic treatment for EBV infection. After several admissions, vasculitis workup and myeloperoxidase-antineutrophil cytoplasmic autoantibody (ANCA) studies were positive. Evolution of clinical symptoms, laboratory parameters and our literature review suggested the diagnosis of EBV-associated ANCA vasculitis. Steroids were started after the patient continued to deteriorate; the viral load started increasing, so we added valganciclovir with favourable clinical response and no relapse during the follow-up for 6 months. This suggests that with evidence of viraemia (primary or reactivation), antiviral treatment likely has clinical benefit while immunosuppression is being considered. |
| Databáze: | OpenAIRE |
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