Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Catalonia, Badalona, Spain.
Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Catalonia, Badalona, Spain.
Dig Liver Dis. 2017 Aug;49(8):934-937. doi: 10.1016/j.dld.2017.03.011. Epub 2017 Mar 28.
Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is a little known entity that can affect the oropharyngeal mucosa, the gastrointestinal tract and the skin. The main risk factor for the development of this lesion is immunosuppression. Because its features are similar to other Epstein-Barr virus-associated lymphoproliferative disorders, a differential diagnosis can sometimes prove challenging. Here, we report the case of a man diagnosed with Crohn's disease and treated with azathioprine and infliximab who developed ulceration at the rectum that was refractory to conventional medical treatment. Although the histological characteristics were suggestive of an EBVMCU, lymphoproliferative disease could not be ruled out. The patient did not improve after discontinuation of the treatment, a proctectomy was performed and the diagnosis of this disease was confirmed. Although very few cases of EBVMCU affecting the colon have been reported, its diagnosis should be always considered in refractory cases of inflammatory bowel disease with patients undergoing immunosuppressive treatment.
EB 病毒阳性黏膜溃疡（EBVMCU）是一种鲜为人知的疾病，可影响口咽黏膜、胃肠道和皮肤。这种病变发展的主要危险因素是免疫抑制。由于其特征与其他 EBV 相关淋巴增生性疾病相似，因此有时鉴别诊断具有一定挑战性。在这里，我们报告了一例诊断为克罗恩病并接受硫唑嘌呤和英夫利昔单抗治疗的患者，他在直肠出现了溃疡，对常规治疗无反应。尽管组织学特征提示为 EBVMCU，但不能排除淋巴增生性疾病。停用治疗后患者并未改善，进行了直肠切除术，最终确诊为这种疾病。尽管报道的累及结肠的 EBVMCU 非常少见，但对于正在接受免疫抑制治疗的炎症性肠病患者，出现难治性疾病时应始终考虑该疾病的诊断。
