Kittan, N. A. and Beier, F. and Kurz, K. and Niller, H. H. and Egger, L. and Jilg, W. and Andreesen, R. and Holler, E. and Hildebrandt, G. C. (2011) Isolated cerebral manifestation of Epstein-Barr virus-associated post-transplant lymphoproliferative disorder after allogeneic hematopoietic stem cell transplantation: a case of clinical and diagnostic challenges. TRANSPLANT INFECTIOUS DISEASE, 13 (5). pp. 524-530. ISSN 1398-2273,
Full text not available from this repository. (Request a copy)Abstract
We present the case of a 49-year-old male patient with Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorder (PTLD) limited to the brain that occurred 6 months after allogeneic hematopoietic stem cell transplantation (HSCT). Clinical symptoms included mental confusion, ataxia, and diplopia. Magnetic resonance imaging (MRI) revealed cerebellar and periventricular lesions consistent with an inflammatory process. Cerebrospinal fluid (CSF) analysis, but not peripheral blood, was positive for EBV-DNA, but no malignant cells were found. Brain biopsy was not feasible because of low platelet counts. As we considered a diagnosis of either EBV-associated encephalitis or PTLD, the patient was treated with rituximab combined with antiviral therapy. However, the cerebral lesions progressed and follow-up CSF testing revealed immunoglobulin H clonality as evidence of a malignant process. Subsequent treatment attempts included 2 donor lymphocyte infusions (DLI). Despite treatment, the patient died from autopsy-proven PTLD within 8 weeks of the onset of symptoms. This case demonstrates the clinical and diagnostic challenges of primary cerebral PTLD in a patient following allogeneic HSCT.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CENTRAL-NERVOUS-SYSTEM; BONE-MARROW-TRANSPLANTATION; REAL-TIME PCR; HEMATOLOGICAL MALIGNANCIES; HERPESVIRUS INFECTIONS; ANTIBODY RITUXIMAB; PROGNOSTIC-FACTORS; EBV REACTIVATION; T-CELLS; DISEASE; post-transplant lymphoproliferative disorder; PTLD; encephalitis; Epstein-Barr virus; EBV; central nervous system; allogeneic stem cell transplantation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene Medicine > Lehrstuhl für Pathologie Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 02 Jun 2020 06:18 |
| Last Modified: | 02 Jun 2020 06:18 |
| URI: | https://pred.uni-regensburg.de/id/eprint/20061 |
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