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Case Reports
. 2021 Aug 1;60(15):2495-2497.
doi: 10.2169/internalmedicine.6702-20. Epub 2021 Feb 15.

Age-related Epstein-Barr Virus-associated Lymphoproliferative Disorder Masquerading as Systemic Lupus Erythematosus

Keiichiro Kadoba  1 , Keisuke Nishimura  1 , Kaori Uchino  2 , Daisuke Waki  1 , Hiroyuki Murabe  1 , Toshihiko Yokota  1
Affiliations
Case Reports

Age-related Epstein-Barr Virus-associated Lymphoproliferative Disorder Masquerading as Systemic Lupus Erythematosus

Keiichiro Kadoba et al. Intern Med. .

Abstract

Age-related Epstein-Barr virus (EBV)-positive B-cell lymphoproliferative disorder (LPD) occurs in elderly patients without immunodeficiency. An 81-year-old woman without any known immunodeficiency was examined for fever, rash, arthritis, thrombocytopenia, pleural and pericardial effusions, lymphadenopathy, and positive autoantibodies, which satisfied the classification criteria for systemic lupus erythematosus (SLE). However, a lymph node biopsy revealed EBV-LPD, and she was diagnosed with age-related EBV-LPD. In young individuals, EBV infection is a major differential diagnosis of SLE, but to our knowledge, this is the first reported case of age-related EBV-LPD mimicking SLE. We should therefore consider EBV-related disorders in the differential diagnosis of SLE even in elderly individuals.

Keywords: Epstein-Barr virus; lymphoproliferative disorder; systemic lupus erythematosus.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure.
Figure.
Histological findings of the axillary lymph node biopsy. (A) Proliferation of heterogeneous cells, including lymphocytes and plasma cells, is observed in the interfollicular space (Hematoxylin and Eosin staining, ×400 magnification). (B) Diversely sized B cells are observed (CD20, ×400 magnification). (C) The proliferating cells tested positive for Epstein-Barr virus-encoding small RNA in situ hybridization (×400 magnification).
See this image and copyright information in PMC

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