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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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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author Indira Acharya
Lanaya Williams Smith
Stuart Mitchell Levine
Huaibin Mabel Ko
Govind Bhagat
Christopher J. Haas
author_facet Indira Acharya
Lanaya Williams Smith
Stuart Mitchell Levine
Huaibin Mabel Ko
Govind Bhagat
Christopher J. Haas
author_sort Indira Acharya
collection DOAJ
description 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.
format Article
id doaj-art-4a0e2957df15493bbb6f4f15c4b2e138
institution OA Journals
issn 2767-7664
language English
publishDate 2024-12-01
publisher American College of Physicians
record_format Article
series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-4a0e2957df15493bbb6f4f15c4b2e1382025-08-20T02:12:57ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-12-0131210.7326/aimcc.2024.0228Epstein-Barr Virus–Associated B-Cell Lymphoproliferative Disorder Involving the Adrenal Gland in Granulomatosis With PolyangiitisIndira Acharya0Lanaya Williams Smith1Stuart Mitchell Levine2Huaibin Mabel Ko3Govind Bhagat4Christopher J. Haas51Medstar Health Internal Medicine Residency Program, Baltimore, Maryland2MedStar Good Samaritan Hospital, Baltimore, Maryland2MedStar Good Samaritan Hospital, Baltimore, Maryland3Columbia University, Irving Medical Center, New York, New York3Columbia University, Irving Medical Center, New York, New York1Medstar Health Internal Medicine Residency Program, Baltimore, MarylandEpstein-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.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0228
spellingShingle Indira Acharya
Lanaya Williams Smith
Stuart Mitchell Levine
Huaibin Mabel Ko
Govind Bhagat
Christopher J. Haas
Epstein-Barr Virus–Associated B-Cell Lymphoproliferative Disorder Involving the Adrenal Gland in Granulomatosis With Polyangiitis
Annals of Internal Medicine: Clinical Cases
title Epstein-Barr Virus–Associated B-Cell Lymphoproliferative Disorder Involving the Adrenal Gland in Granulomatosis With Polyangiitis
title_full Epstein-Barr Virus–Associated B-Cell Lymphoproliferative Disorder Involving the Adrenal Gland in Granulomatosis With Polyangiitis
title_fullStr Epstein-Barr Virus–Associated B-Cell Lymphoproliferative Disorder Involving the Adrenal Gland in Granulomatosis With Polyangiitis
title_full_unstemmed Epstein-Barr Virus–Associated B-Cell Lymphoproliferative Disorder Involving the Adrenal Gland in Granulomatosis With Polyangiitis
title_short Epstein-Barr Virus–Associated B-Cell Lymphoproliferative Disorder Involving the Adrenal Gland in Granulomatosis With Polyangiitis
title_sort epstein barr virus associated b cell lymphoproliferative disorder involving the adrenal gland in granulomatosis with polyangiitis
url https://www.acpjournals.org/doi/10.7326/aimcc.2024.0228
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