The 504th case: Multiple lymph node enlargement, renal insufficiency, blindness, and white matter lesions of the brain
10.3760/cma.j.cn112138-20230922-00150
- VernacularTitle:第504例——多发淋巴结肿大、肾功能不全、失明、脑白质病变
- Author:
Chong WEI
1
;
Zhe ZHUANG
;
Yunlong LI
;
Xiaoxiao SHI
;
Yubing WEN
;
Wei CAO
;
Siyuan FAN
;
Xiao ZHANG
;
Yan ZHANG
;
Wei ZHANG
;
Daobin ZHOU
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院血液内科，北京 100730
- Keywords:
Lymphoma;
Cytomegalovirus retinitis;
Leukoencephalopathy, progressive multifocal;
Angioimmunoblastic T-cell lymphoma;
Polyomavirus associated nephropathy
- From:
Chinese Journal of Internal Medicine
2024;63(3):316-320
- CountryChina
- Language:Chinese
-
Abstract:
A 65-year-old male patient was admitted for recurrent lymph node enlargement for 5 years and elevated creatinine for 6 months. This patient was diagnosed with angioimmunoblastic T-cell lymphoma 5 years ago and underwent multiple lines of anti-tumor therapy, including cytotoxic chemotherapy; epigenetic modifying drugs such as chidamide and azacitidine; the immunomodulator lenalidomide; and targeted therapy such as rituximab, a CD20-targeting antibody, and brentuximab vedotin, which targets CD30. Although the tumor was considered stable, multiple virus activation (including BK virus, JC virus, and cytomegalovirus) accompanied by the corresponding organ damage (polyomavirus nephropathy, cytomegalovirus retinitis, and progressive multifocal leukoencephalopathy) occurred during anti-tumor treatment. Anti-tumor therapy was suspended and ganciclovir was used. The serum viral load decreased and organ functions were stabilized. The purpose of this report was to raise clinicians′ awareness of opportunistic virus reactivation during anti-tumor treatment.
