Epstein-Barr Virus-Associated T-Cell Lymphoproliferative Disorder Presenting as Chronic Diarrhea and Intestinal Bleeding: A Case Report

Front Immunol. 2018 Nov 16:9:2583. doi: 10.3389/fimmu.2018.02583. eCollection 2018.

Abstract

Systemic Epstein-Barr virus-positive T-cell lymphoproliferative childhood disease (EBV+ T-LPD) is extremely rare. Primary acute or chronic active Epstein-Barr virus infection triggers EBV+ T-LPD's onset and the disease involves clonal proliferation of infected T-cells with activated cytotoxic phenotype. The adult-onset EBV+ T-LPD (ASEBV+ T-LPD) is even rarer and needs to be extensively studied. Further, according to literature review, it is a challenge to find patients who are immunocompetent and diagnosed with ASEBV+ T-LPD involving gastrointestinal tract. This case report discusses a previously healthy middle aged woman who presented with unique symptoms mimicking inflammatory bowel disease, and required a total colectomy and terminal ileum rectomy, as reveled by endoscopic examinations, due to severe gastrointestinal bleeding. Post-surgery histopathological findings were confirmatory for the diagnosis of ASEBV+ T-LPD (II: Borderline). This patient died 7 months after the diagnosis.

Keywords: Epstein-Barr virus infection; T-cell lymphoproliferative disease; clinical features; differential diagnosis; endoscopic features.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cell Proliferation
  • Chronic Disease
  • Colectomy
  • Cytotoxicity, Immunologic
  • Diagnosis, Differential
  • Diarrhea
  • Epstein-Barr Virus Infections / diagnosis*
  • Fatal Outcome
  • Female
  • Hemorrhage
  • Herpesvirus 4, Human / physiology
  • Humans
  • Inflammatory Bowel Diseases / diagnosis*
  • Intestines / pathology*
  • Lymphocyte Activation
  • Lymphoproliferative Disorders / diagnosis*
  • Middle Aged
  • T-Lymphocytes / immunology*