Henry Heather L, Fernandez Conrad Vincent, Corsten Gerard
Royal College of Surgeons in Ireland, Medicine, 123 St. Stephen's Green, Dublin 2, Ireland.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.04.2009.1758. Epub 2009 Jun 9.
This report describes an adolescent girl with primary Epstein-Barr virus (EBV) infection in the setting of intensive immunosuppression for a cardiac transplant. She went on to develop progressive pain, weight loss and night sweats with necrosis of the tonsils over 8 weeks. The clinical impression was initially that of a complicated tonsillitis secondary to immune dysfunction. Biopsy 2 months after first presentation demonstrated diffuse B cell lymphoma consistent with post-transplant lymphoproliferative disorder (PTLD). We present this case to highlight the need for a high degree of clinical suspicion for PTLD in a population of patients who commonly experience primary exposure to EBV.
本报告描述了一名青少年女孩，她在接受心脏移植的强化免疫抑制治疗期间发生了原发性爱泼斯坦-巴尔病毒（EBV）感染。在8周的时间里，她逐渐出现进行性疼痛、体重减轻和盗汗，伴有扁桃体坏死。最初的临床印象是继发于免疫功能障碍的复杂性扁桃体炎。首次出现症状2个月后进行的活检显示为弥漫性B细胞淋巴瘤，符合移植后淋巴细胞增生性疾病（PTLD）。我们报告此病例以强调，对于通常初次接触EBV的患者群体，需要对PTLD保持高度的临床怀疑。
