The spectrum of Epstein-Barr virus infections of the central nervous system after organ transplantation

Virology Journal

Pooja Raibagkar¹  Mohamed Ridha²  Michal Vytopil³  David P. Lerner³  Barbara Voetsch³  Dylan G. Jones³  Joseph D. Burns³  Anil Ramineni³ 

[1] Concord Hospital Neurology Associates, 246 Pleasant Street, 03301, Concord, NH, USA;Department of Neurology, University of Cincinnati, 260 Stetson, Suite 2300, 45267, Cincinnati, OH, USA;Division of Neurology, Lahey Hospital and Medical Center, 41 Mall Road, 01805, Burlington, MA, USA;Department of Neurology, Tufts University School of Medicine, 800 Washington Street, 02111, Boston, MA, USA;

关键词: Epstein-Barr virus;    Post-transplant lymphoproliferative disorder;    Central nervous system;   

DOI  :  10.1186/s12985-021-01629-6

来源: Springer

【 摘 要 】

BackgroundEpstein-Barr virus (EBV)-related neurologic complications have a diverse presentation in transplant recipients, creating diagnostic and therapeutic challenges for clinicians. In this case series, we report unique manifestations of EBV related neurologic complications following solid organ transplant and highlight pitfalls in management.Case presentationsA retrospective search of the electronic medical record of all patients from January 2015 to December 2020 who underwent solid organ transplantation and had central nervous system complications as determined by ICD-10 codes were included. Three patients with unique manifestation of EBV-related neurologic complications after liver transplantation were identified. The first was a 52-year-old man with a live-donor liver transplant 11 years prior for Budd-Chiari syndrome presented with several weeks of headache and several lesions on brain MRI; he was diagnosed with primary central nervous system post-transplant lymphoproliferative disorder. The second patient was a 63-year-old man with a deceased-donor liver transplant 16 years prior for alpha-1-antitrypsin deficiency and was found to have a stroke; he was diagnosed with EBV encephalitis. The final patient was a 75-year-old woman with a deceased-donor liver transplant six years prior for primary biliary cirrhosis who presented with four months of gait instability; she was diagnosed with EBV myelitis. A review of the literature was performed to supplement description of the different diseases.ConclusionsEBV-related central nervous infection in post-transplant patients can manifest in a variety of neurologic syndromes, which can be challenging to diagnose. Careful correlation of clinical, pathologic, and radiologic findings and a high index of suspicion are crucial in identification and appropriate management.

【 授权许可】

CC BY