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Epstein‐Barr virus associated post‐transplant lymphoproliferative disorder mimicking acute graft versus host disease
Author(s) -
Prem Shruti,
AlShaibani Zeyad,
Michelis Fotios V.,
Kim Dennis,
Viswabandya Auro,
Lipton Jeffrey Howard,
Kumar Rajat,
Mattsson Jonas,
Law Arjun,
Lam Wilson
Publication year - 2019
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13309
Subject(s) - medicine , diarrhea , differential diagnosis , immune surveillance , disease , post transplant lymphoproliferative disorder , epstein–barr virus infection , lymphoproliferative disease , epstein–barr virus , virus , graft versus host disease , presentation (obstetrics) , immune system , immunology , pathology , gastroenterology , surgery
We present a case series of 3 patients to highlight the fact that PTLD post‐transplant can mimic GVHD , and should be part of the differential diagnosis for diarrhea post allo‐ HCT . Awareness of this presentation has important therapeutic implications, as increased immune suppression for the management of GVHD , can worsen clinical features of PTLD . Diagnostic imaging and tissue biopsies should be undertaken early in post‐transplant patients presenting with diarrhea or hepatic abnormalities, especially with atypical presentations like fever, and EBV PCR monitoring can expedite clinical decision‐making in such complicated scenarios while awaiting results of gut biopsies.