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

• Main Authors: Yaxin Wang, Yajun Li, Xiangwei Meng, Xiumei Duan, Meilan Wang, Wenqing Chen, Tongyu Tang, Yuqin Li
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2018-11-01
• Series: Frontiers in Immunology
• Subjects: Epstein-Barr virus infection; T-cell lymphoproliferative disease; clinical features; endoscopic features; differential diagnosis
• Online Access: https://www.frontiersin.org/article/10.3389/fimmu.2018.02583/full

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.