Chronic active EBV infection with features of granulomatosis with polyangiitis

Abstract

Herein, we report the case of a 13-year-old boy with multiple recurrent ulcers on his legs. He developed severe sinusitis at 10 years of age and had significant weight loss (6 kg) in the 2 months prior to admission. Histology of tissue biopsied from the ulcer indicated small vessel vasculitis and granulomatous inflammation. Given that these findings met the diagnostic criteria for granulomatosis with polyangiitis (GPA), he was treated with immunosuppressive agents. Further pathology, however, indicated Epstein-Barr virus (EBV)-encoded RNA (EBER) in most lymphocytes in the same sample. The EBER-positive lymphocytes were mainly CD4-positive T cells. The EBV-DNA load in the peripheral blood was also abnormally increased (1.0 × 10(4) copies/μg DNA). Thus, the diagnosis was established as chronic active EBV infection (CAEBV). This case illustrates the necessity of careful differential diagnosis of CAEBV owing to its clinical resemblance and pathological overlap with GPA.

Biopsy‐proven case of Epstein–Barr virus (EBV)‐associated vasculitis of the central nervous system

“…These findings suggest that testing for EBV needs to be considered for the accurate diagnosis and classification of CNS vasculitis. Only one study has reported a case of chronic active EBV infection with the features of granulomatosis with polyangiitis because it is very rare . Other studies have described encephalitis due to EBV with HIV infection; on the other hand, our case was HIV‐negative, and thus, EBV may have played a more significant role in the development of vasculitis.…”

Anti-Neutrophilic Cytoplasmic Antibody (ANCA) Vasculitis Presented as Pulmonary Hemorrhage in a Positive COVID-19 Patient: A Case Report

“…Sixty to seventy percent of the patients are carrier of this organism in their nasal canals. Apart from S. aureus, other organisms are: Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, hepatitis C virus (HCV), Epstein-Barr virus (EBV) and Helicobacter pylori [ 5 , 6 ].…”