Epstein-Barr Virus Induced Post-transplant Lymphoproliferative Disorder Presenting with Unilateral Retinal Involvement

Overview

Journal Am J Ophthalmol Case Rep

Specialty Ophthalmology

Date 2021 Aug 19

PMID 34409196

Citations 2

Authors

Mainguy Adam

Philippakis Elise

Aurelien Sutra Del Galy

Stanescu-Segall Dinu

Tadayoni Ramin

Bodaghi Bahram

Bonnin Sophie

Touhami Sara

Affiliations

Soon will be listed here.

Abstract

Purpose: Post-transplant lymphoproliferative disorder (PTLD) represents a spectrum of disorders associated with Epstein Barr Virus infection in up to 80% of cases in the setting of pharmacologic immunosuppression following hematopoietic stem cell or solid organ transplantation. Ocular involvement is a rare finding in PTLD.

Observation: We report the case of a 38-year-old man who presented with unilateral retinal infiltrates as first manifestation of PTLD relapse. Diagnosis relied on the presence of EBV DNA in anterior chamber fluids and vitrectomy that showed the presence of a B cell clone. Systemic relapse of PTLD was detected 12 weeks after retinal findings. Treatment of ocular disease included systemic injections of rituximab and intravitreal injections of methotrexate, halting the extension of retinal infiltrates.

Conclusion: Ocular involvement in PTLD is rare and needs to be acknowledged because it can precede a systemic relapse of the hematological condition.

Citing Articles

Case report: A rare EBV-associated T/NK cell monomorphic posttransplant lymphoproliferative disorder.

Jiang X, Zhang Y, Li X, Li X, Li Z, Meng W Front Immunol. 2024; 15:1491681.

PMID: 39512350 PMC: 11540687. DOI: 10.3389/fimmu.2024.1491681.

Epstein-Barr virus-positive iris diffuse large B-cell lymphoma detected by metagenomic next-generation sequencing.

Wang X, Hong J, Xu Y, Zhang P, Li Y, Dou H BMC Ophthalmol. 2024; 24(1):99.

PMID: 38438866 PMC: 10913400. DOI: 10.1186/s12886-024-03334-8.

References

Demols P, Cochaux P, Velu T, Caspers-Velu L . Chorioretinal post-transplant lymphoproliferative disorder induced by the Epstein-Barr virus. Br J Ophthalmol. 2001; 85(1):93-5. PMC: 1723697. DOI: 10.1136/bjo.85.1.93. View

Walton R, Onciu M, Irshad F, Wilson T . Conjunctival posttransplantation lymphoproliferative disorder. Am J Ophthalmol. 2007; 143(6):1050-1. DOI: 10.1016/j.ajo.2007.01.038. View

Fujimoto A, Suzuki R . Epstein-Barr Virus-Associated Post-Transplant Lymphoproliferative Disorders after Hematopoietic Stem Cell Transplantation: Pathogenesis, Risk Factors and Clinical Outcomes. Cancers (Basel). 2020; 12(2). PMC: 7072403. DOI: 10.3390/cancers12020328. View

Loren A, Porter D, Stadtmauer E, Tsai D . Post-transplant lymphoproliferative disorder: a review. Bone Marrow Transplant. 2003; 31(3):145-55. DOI: 10.1038/sj.bmt.1703806. View

Pagliuca S, Bommier C, Michonneau D, Meignin V, Salmona M, Robin M . Epstein-Barr Virus-Associated Post-Transplantation Lymphoproliferative Disease in Patients Who Received Anti-CD20 after Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant. 2019; 25(12):2490-2500. DOI: 10.1016/j.bbmt.2019.08.006. View

Mastropasqua R, Thaung C, Pavesio C, Lightman S, Westcott M, Okhravi N . The Role of Chorioretinal Biopsy in the Diagnosis of Intraocular Lymphoma. Am J Ophthalmol. 2015; 160(6):1127-1132.e1. DOI: 10.1016/j.ajo.2015.08.033. View

Iu L, Yeung J, Loong F, Chiang A . Successful treatment of intraocular post-transplant lymphoproliferative disorder with intravenous rituximab. Pediatr Blood Cancer. 2014; 62(1):169-72. DOI: 10.1002/pbc.25223. View

Kheterpal S, Kirkby G, Neuberger J, Rosenthal A, Murray P . Intraocular lymphoma after liver transplantation. Am J Ophthalmol. 1993; 116(4):507-8. DOI: 10.1016/s0002-9394(14)71416-3. View

Traum A, Rodig N, Pilichowska M, Somers M . Central nervous system lymphoproliferative disorder in pediatric kidney transplant recipients. Pediatr Transplant. 2006; 10(4):505-12. DOI: 10.1111/j.1399-3046.2006.00497.x. View

10.

Costopoulos M, Touitou V, Golmard J, Darugar A, Fisson S, Bonnemye P . ISOLD: A New Highly Sensitive Interleukin Score for Intraocular Lymphoma Diagnosis. Ophthalmology. 2016; 123(7):1626-8. DOI: 10.1016/j.ophtha.2016.01.037. View

11.

Koenig K, Briese S, Wiemann D, Haffner D, Querfeld U . Post-transplantation swelling of the lower eyelid. Nephrol Dial Transplant. 2004; 19(4):1001-3. DOI: 10.1093/ndt/gfg597. View

12.

Al-Attar L, Berrocal A, Warman R, Dubovy S, Paredes A, Chan C . Diagnosis by polymerase chain reaction of ocular posttransplant lymphoproliferative disorder after pediatric renal transplantation. Am J Ophthalmol. 2004; 137(3):569-71. DOI: 10.1016/j.ajo.2003.08.013. View

13.

Cho A, Holland G, Glasgow B, Isenberg S, George B, McDiarmid S . Ocular involvement in patients with posttransplant lymphoproliferative disorder. Arch Ophthalmol. 2001; 119(2):183-9. View