Epstein-Barr Virus–Associated B-Cell Lymphoproliferative Disorder Involving the Adrenal Gland in Granulomatosis With Polyangiitis

Epstein-Barr virus (EBV)–associated lymphoproliferative disorders (LPDs) are rare conditions. Immunomodulatory therapies impair T-cell–mediated immune responses to latent EBV-infected memory B cells, promoting their reactivation and leading to the excessive division of infected cells, which can resu...

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Bibliographic Details
Main Authors: Indira Acharya, Lanaya Williams Smith, Stuart Mitchell Levine, Huaibin Mabel Ko, Govind Bhagat, Christopher J. Haas
Format: Article
Language:English
Published: American College of Physicians 2024-12-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2024.0228
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Summary:Epstein-Barr virus (EBV)–associated lymphoproliferative disorders (LPDs) are rare conditions. Immunomodulatory therapies impair T-cell–mediated immune responses to latent EBV-infected memory B cells, promoting their reactivation and leading to the excessive division of infected cells, which can result in the development of EBV-associated lymphocyte proliferations. Lymphoproliferative disorders related to immunomodulatory agents are recognized as potential life-threatening complications of prolonged immunomodulator administration. Methotrexate-associated LPDs in rheumatoid arthritis and azathioprine-associated LPDs in inflammatory bowel disease have been reported previously. To our knowledge, we report a unique and possibly the first documented case of a B-cell LPD, specifically an EBV-associated polymorphic LPD, involving the adrenal gland in a patient with granulomatosis with polyangiitis treated with azathioprine.
ISSN:2767-7664