EBV-Associated Leukoencephalopathy with Late Onset of Central Nervous System Lymphoma in a Kidney Transplant Recipient
| Autor: | Augusto Vaglio, F Bacci, Umberto Maggiore, Lucio Manenti, Alessandra Palmisano, Carlo Buzio, L. Bignardi, E. Chierici, C Mancini, Rocco Cobelli |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Herpesvirus 4 Human Pathology medicine.medical_specialty Lymphoma Encephalopathy Antiviral Agents Leukoencephalopathy Cerebrospinal fluid Leukoencephalopathies hemic and lymphatic diseases medicine Humans Immunology and Allergy Pharmacology (medical) Kidney transplantation Transplantation Brain Neoplasms business.industry medicine.disease Kidney Transplantation Magnetic Resonance Imaging Hyperintensity Tumor Virus Infections Positron-Emission Tomography Kidney Failure Chronic Female business Complication |
| Zdroj: | American Journal of Transplantation. 10:947-951 |
| ISSN: | 1600-6135 |
| DOI: | 10.1111/j.1600-6143.2009.02999.x |
| Popis: | Central nervous system (CNS) lymphoma is a rare posttransplant lymphoproliferative disorder (PTLD), which usually has a poor outcome. To date, no specific conditions predisposing to this complication have been identified. We here describe the case of a renal transplant patient who was initially diagnosed as having Epstein-Barr virus (EBV)-associated leukoencephalopathy and ultimately developed EBV-positive CNS lymphoma. The patient was a young lady who, 2 years after transplantation, presented with focal neurological and electroencephalographic abnormalities and diffuse white matter lesions on brain magnetic resonance imaging. EBV-DNA was detected in the cerebrospinal fluid (CSF) by polymerase chain reaction. After acyclovir therapy and immunosuppressive drug tapering, the symptoms and electroencephalographic abnormalities subsided, and EBV-DNA disappeared from the CSF. Ten years later, a bulky cerebral mass was found. After excision, a diagnosis of EBV-positive, Hodgkin-like monomorphic B-cell PTLD was made. This case illustrates the potential pathophysiological relationships between EBV infection, leukoencephalopathy and CNS lymphoma; although a long time elapsed from the initial neurological illness to CNS lymphoma, a link between these two conditions cannot be excluded. Therefore, a careful long-term follow-up of EBV-related encephalopathy is advisable. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text