Epstein-Barr Virus Infection in an Elderly Nonimmunocompromised Adult Successfully Treated with Rituximab

Epstein-Barr virus (EBV) is a ubiquitous virus that commonly affects children and adolescents. In addition to causing a viral illness, it is also associated with various malignancies in particular B cell lymphomas and lymphoproliferative disorders. Differentiating between the two processes can be...

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Main Authors: Jacob P. Smeltzer, Matthew T. Howard, Wilson I. Gonsalves, Thomas E. Witzig
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2014/641483
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author Jacob P. Smeltzer
Matthew T. Howard
Wilson I. Gonsalves
Thomas E. Witzig
author_facet Jacob P. Smeltzer
Matthew T. Howard
Wilson I. Gonsalves
Thomas E. Witzig
author_sort Jacob P. Smeltzer
collection DOAJ
description Epstein-Barr virus (EBV) is a ubiquitous virus that commonly affects children and adolescents. In addition to causing a viral illness, it is also associated with various malignancies in particular B cell lymphomas and lymphoproliferative disorders. Differentiating between the two processes can be a diagnostic challenge. Here, we present a case of an atypical EBV infection in an elderly patient with severe systemic symptoms, multiorgan involvement, lymphadenopathy, and negative EBV serology. Excisional lymph node biopsy demonstrated features of a lymphoproliferative process involving EBV. Despite supportive care, she experienced continued clinical deterioration and was successfully treated with rituximab. This case illustrates the diagnostic challenges of these cases particularly in the elderly who may have age related immunosenescence, the utility of EBV PCR testing, and the clinical efficacy of rituximab in clearing the infected cells.
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spelling doaj-art-94eca9c28b794f109d921586f59a1f3c2025-02-03T01:03:49ZengWileyCase Reports in Hematology2090-65602090-65792014-01-01201410.1155/2014/641483641483Epstein-Barr Virus Infection in an Elderly Nonimmunocompromised Adult Successfully Treated with RituximabJacob P. Smeltzer0Matthew T. Howard1Wilson I. Gonsalves2Thomas E. Witzig3Division of Hematology, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USADivision of Hematopathology, Department of Laboratory Medicine and Pathology, 200 First Street SW, Rochester, Minnesota, MN 55905, USADivision of Hematology, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USADivision of Hematology, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USAEpstein-Barr virus (EBV) is a ubiquitous virus that commonly affects children and adolescents. In addition to causing a viral illness, it is also associated with various malignancies in particular B cell lymphomas and lymphoproliferative disorders. Differentiating between the two processes can be a diagnostic challenge. Here, we present a case of an atypical EBV infection in an elderly patient with severe systemic symptoms, multiorgan involvement, lymphadenopathy, and negative EBV serology. Excisional lymph node biopsy demonstrated features of a lymphoproliferative process involving EBV. Despite supportive care, she experienced continued clinical deterioration and was successfully treated with rituximab. This case illustrates the diagnostic challenges of these cases particularly in the elderly who may have age related immunosenescence, the utility of EBV PCR testing, and the clinical efficacy of rituximab in clearing the infected cells.http://dx.doi.org/10.1155/2014/641483
spellingShingle Jacob P. Smeltzer
Matthew T. Howard
Wilson I. Gonsalves
Thomas E. Witzig
Epstein-Barr Virus Infection in an Elderly Nonimmunocompromised Adult Successfully Treated with Rituximab
Case Reports in Hematology
title Epstein-Barr Virus Infection in an Elderly Nonimmunocompromised Adult Successfully Treated with Rituximab
title_full Epstein-Barr Virus Infection in an Elderly Nonimmunocompromised Adult Successfully Treated with Rituximab
title_fullStr Epstein-Barr Virus Infection in an Elderly Nonimmunocompromised Adult Successfully Treated with Rituximab
title_full_unstemmed Epstein-Barr Virus Infection in an Elderly Nonimmunocompromised Adult Successfully Treated with Rituximab
title_short Epstein-Barr Virus Infection in an Elderly Nonimmunocompromised Adult Successfully Treated with Rituximab
title_sort epstein barr virus infection in an elderly nonimmunocompromised adult successfully treated with rituximab
url http://dx.doi.org/10.1155/2014/641483
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