Mashima Kiyomi, Yano Shingo, Yokoyama Hiroki, Saito Takeshi, Machishima Tomohito, Shimada Takaki, Yahagi Yuichi, Takahara Shinobu, Sugiyama Katsuki, Ogasawara Yoji, Minami Jiro, Kamiyama Yutaro, Katsube Atsushi, Suzuki Kazuhito, Ohshima Sayaka, Yamada Hisashi, Usui Noriko, Aiba Keisuke
Department of Oncology and Hematology, The Jikei University School of Medicine, Japan.
Intern Med. 2017;56(6):701-706. doi: 10.2169/internalmedicine.56.7722. Epub 2017 Mar 17.
Epstein-Barr virus (EBV)-associated lymphoproliferative disorders (LPDs) sometimes occur following Anti-thymocyte globulin (ATG) administration for allogenic stem cell transplantation but are rare in aplastic anemia (AA) patients. A 55-year-old woman with AA following ATG developed refractory fever and was diagnosed with EBV-LPD. She was successfully treated with weekly rituximab monotherapy; however, she developed EBV encephalitis. She was admitted to the intensive care unit and finally recovered from unconsciousness. EBV-LPD should be considered after ATG for AA when symptoms appear. Because EBV-LPD following ATG for AA can rapidly progress, weekly monitoring of EBV-DNA and early intervention may be necessary.
爱泼斯坦-巴尔病毒（EBV）相关的淋巴增殖性疾病（LPDs）有时会在同种异体干细胞移植使用抗胸腺细胞球蛋白（ATG）后发生，但在再生障碍性贫血（AA）患者中罕见。一名55岁接受过ATG治疗的AA女性出现难治性发热，被诊断为EBV-LPD。她接受每周一次的利妥昔单抗单药治疗后获得成功；然而，她发生了EBV脑炎。她被收入重症监护病房，最终从昏迷中康复。当AA患者接受ATG治疗后出现症状时，应考虑EBV-LPD。因为AA患者接受ATG治疗后发生的EBV-LPD可能迅速进展，所以可能有必要每周监测EBV-DNA并进行早期干预。
