Presentation
A 76-year-old Japanese female with a 10-year history of RA, who was treated with MTX and infliximab, presented with a tumorous lesion in the gingiva. [ncbi.nlm.nih.gov]
Presented at: 2015 AACR Annual Meeting; April 18-22, 2015; Philadelphia, PA. Abstract 8841. [onclive.com]
Immune System
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Cervical Lymphadenopathy
A 17-year-old boy with fever and cervical lymphadenopathy developed multiple-organ failure and died three weeks after hospital admission. [ncbi.nlm.nih.gov]
In addition, despite 3 cycles of chemotherapy he had persistent cervical lymphadenopathy, hepatosplenomegaly, and high EBV viral load on PCR. [journals.lww.com]
On day 34 right cervical lymphadenopathy was noted and ultrasonography confirmed three enlarged, inhomogeneous and echopenic lymph nodes with a maximum size of 14 15 mm. [springerplus.springeropen.com]
Entire Body System
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Pathologist
This is the first documented case of an azacitidine-associated lymphoproliferative disease, raising awareness for possible not yet known side effects of this drug, which should be kept in mind by oncologists and pathologists. [ncbi.nlm.nih.gov]
A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. [dovemed.com]
All EBV cHL cases had been examined in our previous study. 28 All cases were independently reviewed by 6 pathologists (authors N.A., J. [bloodjournal.org]
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Adrenal Gland Neoplasm
[Indexed for MEDLINE] Free full text Publication type, MeSH terms, Substances Publication type Case Reports MeSH terms Adrenal Gland Neoplasms/diagnosis Adrenal Gland Neoplasms/drug therapy Adrenal Gland Neoplasms/etiology* Adrenal Gland Neoplasms/virology [ncbi.nlm.nih.gov]
Respiratoric
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Respiratory Insufficiency
The patient rapidly deteriorated and finally died of respiratory insufficiency. [ncbi.nlm.nih.gov]
On day 111, the patient began to have signs of respiratory insufficiency. [nejm.org]
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Sputum
Two weeks after initiation of TB therapy the patient had completely recovered from all infectious symptoms and sputum samples turned negative for M. tuberculosis. [springerplus.springeropen.com]
Psychiatrical
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Suggestibility
The clinical course suggests caution when using newer immunosuppressive drugs for treatment of CLL, especially in the context of additional purine analog therapy. [ncbi.nlm.nih.gov]
Workup
Infectious Mononucleosis Workup. Medscape. Available online at . Accessed June 13, 2016. (Aug 2004) Hess, R. Routine Epstein-Barr Virus Diagnostics from the Laboratory Perspective: Still Challenging after 35 Years. Journal of Clinical Microbiology. [labtestsonline.it]
In contrast, PCR analysis of lymph-node-biopsy specimens from 22 seropositive patients undergoing a workup for metastatic cancer failed to reveal EBV (data not shown). [nejm.org]
See Workup. The cornerstone of initial management of PTLD is reduction or withdrawal of immunosuppression, which in some situations may reverse the lymphoproliferative process. [emedicine.medscape.com]
X-Ray
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Pulmonary Infiltrate
Post-transplant lymphoproliferative disorders can occur after autologous BMT and should be included in the differential diagnosis of patients with persistent fever, adenopathy or pulmonary infiltrates. [ncbi.nlm.nih.gov]
Two days later, a new chest x-ray revealed increasing pulmonary infiltrates. EBV-DNA was detected in the bronchoalveolar fluid and at extremely high levels in plasma and peripheral blood lymphocytes ( Figure 1B and C ). [haematologica.org]
On day 85, dyspnea and tachypnea developed, and progressive bilateral pulmonary infiltrates were apparent on a chest film. On day 87, the patient received a dose of donor leukocytes without incident. [nejm.org]
Treatment
Recurring tumors have worse prognosis compared to tumors that do not recur Response to treatment: Tumors that respond to treatment have better prognosis compared to tumors that do not respond to treatment Progression of the condition makes the outcome [dovemed.com]
The clinical course suggests caution when using newer immunosuppressive drugs for treatment of CLL, especially in the context of additional purine analog therapy. [ncbi.nlm.nih.gov]
The 11-130 trial continues to explore treatment with EBV-CTLs for patients with EBV-LPD, and is currently recruiting participants at MSK. [onclive.com]
Full Title An Evaluation of the Toxicity and Therapeutic Effects of Epstein-Barr Virus (EBV)-Immune T-Lymphocytes Derived From Normal HLA-Compatible or Haplotype-Matched Donor in the Treatment of EBV-Associated Lymphoproliferative Diseases or Malignancies [mskcc.org]
Prognosis
[…] generally have poorer prognosis than younger individuals The size of the tumor: Individuals with small-sized tumors fare better than those with large-sized tumors Individuals with bulky disease have a poorer prognosis Involvement of vital organs may [dovemed.com]
Further chapters are devoted to treatment, prognosis, preventive and pre-emptive strategies, and organ-specific considerations. [books.google.com]
It has been reported that an elevated sIL2R value ( 1500 U/mL) indicates poor prognosis in a variety of B-cell lymphomas [ 22 ]. [jmedicalcasereports.biomedcentral.com]
As predicted by the clinical profile, aEBVLPD had a significantly poorer prognosis than EBV cHL ( P .001). [bloodjournal.org]
Diagnosis, Prognosis and Treatment Microbiology for Surgical Infections: analysis, analysis and remedy explores present tendencies in etiology and antibiotic resistance of pathogens answerable for devastating and complicated surgical infections. [theme.pemavis.de]
Etiology
Antineoplastic Agents/administration & dosage Antineoplastic Agents/adverse effects* Antineoplastic Agents/therapeutic use Epstein-Barr Virus Infections/diagnosis Epstein-Barr Virus Infections/drug therapy* Epstein-Barr Virus Infections/etiology Female [ncbi.nlm.nih.gov]
The etiology of EBV B-cell proliferation in these patients remains unknown, although a tolerogenic immune state has been reported as a possible cause [ 13 ]. [jmedicalcasereports.biomedcentral.com]
Diagnosis, Prognosis and Treatment Microbiology for Surgical Infections: analysis, analysis and remedy explores present tendencies in etiology and antibiotic resistance of pathogens answerable for devastating and complicated surgical infections. [theme.pemavis.de]
(Etiology) Lymphocytes are a type of white blood cells that are responsible for providing immunity in the human body. B-cells and T-cells are the two different types of lymphocytes. [dovemed.com]
The etiology of CAEBV is uncertain. 46 EBV stimulates secretion of a variety of cytokines and chemokines in both EBV-infected cells and non-infected cells. [nature.com]
Epidemiology
The epidemiology is reviewed, and careful attention is paid to the role of Epstein-Barr virus in their development. [books.google.com]
Lymphoproliferative disorders after adult kidney transplant: epidemiology and comparison of registry report with claims-based diagnoses. Am J Kidney Dis. 2011 Dec. 58(6):971-80. [Medline]. Khedmat H, Taheri S. [emedicine.medscape.com]
Clinical Epidemiology of Inflammatory Bowel Disease: Incidence, Prevalence, and Environmental Influences. Gastroenterology. 2004;126:1504–1517. 2 Kappelman MD, et al. [pfizer.com]
EBV and MS connection – Epidemiology Annals of neurology. 2010;67(6):824-830. doi:10.1002/ana.21978. Primary Infection with the Epstein-Barr Virus and Risk of Multiple Sclerosis. View Citation Levin LI, Munger KL, O’Reilly EJ, Falk KI, Ascherio A. [atarabio.com]
Epidemiological differences are seen in different geographic pockets. For example, EBV-positive DLBCL is more commonly reported in East Asia compared with Western countries. [nature.com]
Pathophysiology
EBV potential connection to the Pathophysiology of MS Clinical & Translational Immunology. 2017;6(1):e126-. doi:10.1038/cti.2016.87. Defective T-cell control of Epstein–Barr virus infection in multiple sclerosis. [atarabio.com]
Pathophysiology The vast majority of cases of posttransplant lymphoproliferative disease (PTLD) are caused by Epstein-Barr virus (EBV) infection. [5, 6] EBV is a herpes virus that is thought to infect up to 95% of the adult population. [7] Primary infection [emedicine.medscape.com]
Viral lymphomagenesis: from pathophysiology to the rationale for novel therapies. Br J Haematol 2014; 165 : 300–315. 4. Sixbey JW, Nedrud JG, Raab-Traub N, Hanes RA, Pagano JS. Epstein-Barr virus replication in oropharyngeal epithelial cells. [nature.com]
Prevention
Recognition of this reactive condition is important to prevent overtreatment. [ncbi.nlm.nih.gov]
The study will determine if EBV-specific IE cells can be used to prevent EBV infections and treat EBV-related diseases. [isrctn.com]
Further chapters are devoted to treatment, prognosis, preventive and pre-emptive strategies, and organ-specific considerations. [books.google.com]
How can Age-Related EBV-Associated B-Cell Lymphoproliferative Disorders be Prevented? Presently, the cause of Age-Related EBV-Associated B-Cell Lymphoproliferative Disorders is unknown and there are no known methods to prevent their occurrence. [dovemed.com]
Reddy N, Rezvani K, Barrett AJ, Savani BN: Strategies to prevent EBV reactivation and posttransplant lymphoproliferative disorders (PTLD) after allogeneic stem cell transplantation in high-risk patients. Biol Blood Marrow Transplant 2011;17:591-597. [karger.com]