Epstein-Barr virus myelitis and Castleman's disease in a patient with acquired immune deficiency syndrome

A case report

Costantine Albany, George Psevdos, Jasminka Balderacchi, Victoria L. Sharp

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction. Few cases of Epstein-Barr virus myelitis have been described in the literature. Multi-centric Castleman's disease is a lymphoproliferative disorder that is well known for its associations with the human immunodeficiency virus, human herpes virus 8, and Kaposi's sarcoma. The concurrent presentation of these two diseases in a patient at the same time is extremely unusual. Case Presentation. We describe the case of a 43-year-old Caucasian man with acquired immune deficiency syndrome who presented with fever, weight loss and diffuse lymphadenopathy, and was diagnosed with multi-centric Castleman's disease. He presented three weeks later with lower extremity weakness and urinary retention, at which time cerebrospinal fluid contained lymphocytic pleocytosis and elevated protein. Magnetic resonance imaging demonstrated abnormal spinal cord signal intensity over several cervical and thoracic segments, suggesting the diagnosis of myelitis. Our patient was ultimately diagnosed with Epstein-Barr virus myelitis, as Epstein-Barr virus DNA was detected by polymerase chain reaction in the cerebrospinal fluid. Conclusion: To the best of our knowledge, this is the first case of multi-centric Castleman's disease followed by acute Epstein-Barr virus myelitis in a human immunodeficiency virus-infected patient. Clinicians caring for human immunodeficiency virus-infected patients should be vigilant about monitoring patients with increasing lymphadenopathy, prompting thorough diagnostic investigations when necessary.

Original languageEnglish (US)
Article number209
JournalJournal of Medical Case Reports
Volume5
DOIs
StatePublished - 2011
Externally publishedYes

Fingerprint

Myelitis
Giant Lymph Node Hyperplasia
Virus Diseases
Human Herpesvirus 4
Acquired Immunodeficiency Syndrome
HIV
Cerebrospinal Fluid
Urinary Retention
Lymphoproliferative Disorders
Kaposi's Sarcoma
Leukocytosis
Physiologic Monitoring
Weight Loss
Lower Extremity
Spinal Cord
Fever
Thorax
Magnetic Resonance Imaging
Viruses
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Epstein-Barr virus myelitis and Castleman's disease in a patient with acquired immune deficiency syndrome : A case report. / Albany, Costantine; Psevdos, George; Balderacchi, Jasminka; Sharp, Victoria L.

In: Journal of Medical Case Reports, Vol. 5, 209, 2011.

Research output: Contribution to journalArticle

Albany, Costantine ; Psevdos, George ; Balderacchi, Jasminka ; Sharp, Victoria L. / Epstein-Barr virus myelitis and Castleman's disease in a patient with acquired immune deficiency syndrome : A case report. In: Journal of Medical Case Reports. 2011 ; Vol. 5.
@article{51230bf9fd1140f9b2d94a11ce334a55,
title = "Epstein-Barr virus myelitis and Castleman's disease in a patient with acquired immune deficiency syndrome: A case report",
abstract = "Introduction. Few cases of Epstein-Barr virus myelitis have been described in the literature. Multi-centric Castleman's disease is a lymphoproliferative disorder that is well known for its associations with the human immunodeficiency virus, human herpes virus 8, and Kaposi's sarcoma. The concurrent presentation of these two diseases in a patient at the same time is extremely unusual. Case Presentation. We describe the case of a 43-year-old Caucasian man with acquired immune deficiency syndrome who presented with fever, weight loss and diffuse lymphadenopathy, and was diagnosed with multi-centric Castleman's disease. He presented three weeks later with lower extremity weakness and urinary retention, at which time cerebrospinal fluid contained lymphocytic pleocytosis and elevated protein. Magnetic resonance imaging demonstrated abnormal spinal cord signal intensity over several cervical and thoracic segments, suggesting the diagnosis of myelitis. Our patient was ultimately diagnosed with Epstein-Barr virus myelitis, as Epstein-Barr virus DNA was detected by polymerase chain reaction in the cerebrospinal fluid. Conclusion: To the best of our knowledge, this is the first case of multi-centric Castleman's disease followed by acute Epstein-Barr virus myelitis in a human immunodeficiency virus-infected patient. Clinicians caring for human immunodeficiency virus-infected patients should be vigilant about monitoring patients with increasing lymphadenopathy, prompting thorough diagnostic investigations when necessary.",
author = "Costantine Albany and George Psevdos and Jasminka Balderacchi and Sharp, {Victoria L.}",
year = "2011",
doi = "10.1186/1752-1947-5-209",
language = "English (US)",
volume = "5",
journal = "Journal of Medical Case Reports",
issn = "1752-1947",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Epstein-Barr virus myelitis and Castleman's disease in a patient with acquired immune deficiency syndrome

T2 - A case report

AU - Albany, Costantine

AU - Psevdos, George

AU - Balderacchi, Jasminka

AU - Sharp, Victoria L.

PY - 2011

Y1 - 2011

N2 - Introduction. Few cases of Epstein-Barr virus myelitis have been described in the literature. Multi-centric Castleman's disease is a lymphoproliferative disorder that is well known for its associations with the human immunodeficiency virus, human herpes virus 8, and Kaposi's sarcoma. The concurrent presentation of these two diseases in a patient at the same time is extremely unusual. Case Presentation. We describe the case of a 43-year-old Caucasian man with acquired immune deficiency syndrome who presented with fever, weight loss and diffuse lymphadenopathy, and was diagnosed with multi-centric Castleman's disease. He presented three weeks later with lower extremity weakness and urinary retention, at which time cerebrospinal fluid contained lymphocytic pleocytosis and elevated protein. Magnetic resonance imaging demonstrated abnormal spinal cord signal intensity over several cervical and thoracic segments, suggesting the diagnosis of myelitis. Our patient was ultimately diagnosed with Epstein-Barr virus myelitis, as Epstein-Barr virus DNA was detected by polymerase chain reaction in the cerebrospinal fluid. Conclusion: To the best of our knowledge, this is the first case of multi-centric Castleman's disease followed by acute Epstein-Barr virus myelitis in a human immunodeficiency virus-infected patient. Clinicians caring for human immunodeficiency virus-infected patients should be vigilant about monitoring patients with increasing lymphadenopathy, prompting thorough diagnostic investigations when necessary.

AB - Introduction. Few cases of Epstein-Barr virus myelitis have been described in the literature. Multi-centric Castleman's disease is a lymphoproliferative disorder that is well known for its associations with the human immunodeficiency virus, human herpes virus 8, and Kaposi's sarcoma. The concurrent presentation of these two diseases in a patient at the same time is extremely unusual. Case Presentation. We describe the case of a 43-year-old Caucasian man with acquired immune deficiency syndrome who presented with fever, weight loss and diffuse lymphadenopathy, and was diagnosed with multi-centric Castleman's disease. He presented three weeks later with lower extremity weakness and urinary retention, at which time cerebrospinal fluid contained lymphocytic pleocytosis and elevated protein. Magnetic resonance imaging demonstrated abnormal spinal cord signal intensity over several cervical and thoracic segments, suggesting the diagnosis of myelitis. Our patient was ultimately diagnosed with Epstein-Barr virus myelitis, as Epstein-Barr virus DNA was detected by polymerase chain reaction in the cerebrospinal fluid. Conclusion: To the best of our knowledge, this is the first case of multi-centric Castleman's disease followed by acute Epstein-Barr virus myelitis in a human immunodeficiency virus-infected patient. Clinicians caring for human immunodeficiency virus-infected patients should be vigilant about monitoring patients with increasing lymphadenopathy, prompting thorough diagnostic investigations when necessary.

UR - http://www.scopus.com/inward/record.url?scp=79957456031&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79957456031&partnerID=8YFLogxK

U2 - 10.1186/1752-1947-5-209

DO - 10.1186/1752-1947-5-209

M3 - Article

VL - 5

JO - Journal of Medical Case Reports

JF - Journal of Medical Case Reports

SN - 1752-1947

M1 - 209

ER -