Two rare cases of Epstein-Barr virus-associated lymphoproliferative disorders in inflammatory bowel disease patients on thiopurines and other immunosuppressive medications

Intern Med J. 2013 Dec;43(12):1339-42. doi: 10.1111/imj.12287.

Abstract

The setting of chronic immunosuppression in inflammatory bowel disease (IBD) may promote the proliferation of Epstein-Barr virus-positive neoplastic clones. We report two rare cases of Epstein-Barr virus-associated lymphoproliferative disorder in IBD patients: one resembled lymphomatoid granulomatosis, and the other was a lymphoma resembling Hodgkin lymphoma. There are currently no guidelines for the prevention of lymphoproliferative disorder in IBD patients on immunosuppressive therapy.

Keywords: Epstein-Barr virus; immunosuppression; inflammatory bowel disease; lymphoma; lymphoproliferative disorder.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Chronic Disease
  • Epstein-Barr Virus Infections / complications*
  • Epstein-Barr Virus Infections / diagnosis
  • Epstein-Barr Virus Infections / drug therapy*
  • Fatal Outcome
  • Female
  • Herpesvirus 4, Human / isolation & purification
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Inflammatory Bowel Diseases / diagnosis
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / etiology*
  • Lymphoproliferative Disorders / diagnosis
  • Lymphoproliferative Disorders / drug therapy*
  • Lymphoproliferative Disorders / etiology*
  • Male
  • Mercaptopurine / therapeutic use*

Substances

  • Immunosuppressive Agents
  • Mercaptopurine