Persistent Anemia in a Patient with Diffuse Large B Cell Lymphoma: Pure Red Cell Aplasia Associated with Latent Epstein-Barr Virus Infection in Bone Marrow.
10.3346/jkms.2007.22.S.S167
- Author:
Hwa Jung SUNG
1
;
Seok Jin KIM
;
Ji Hye LEE
;
Goeun LEE
;
Kyung A LEE
;
Chul Won CHOI
;
Byung Soo KIM
;
Jun Suk KIM
Author Information
1. Division of Hematology and Oncology, Department of Internal Medicine, Korea University Medical Center, Seoul, Korea. kstwoh@korea.ac.kr
- Publication Type:Case Report
- Keywords:
Red-Cell Aplasia;
Epstein-Barr Virus;
Lymphoma
- MeSH:
Adult;
Bone Marrow/pathology;
Bone Marrow Diseases/*complications/diagnosis/pathology;
Bone Marrow Neoplasms/pathology;
Diagnosis, Differential;
Epstein-Barr Virus Infections/*complications/diagnosis;
Humans;
Lymphoma, Large B-Cell, Diffuse/*complications/pathology;
Male;
Red-Cell Aplasia, Pure/diagnosis/*etiology
- From:Journal of Korean Medical Science
2007;22(Suppl):S167-S170
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a case of pure red cell aplasia (PRCA), which was initially suspected as a result of bone marrow involvement of diffuse large B cell lymphoma. Persistent anemia without an obvious cause was observed in a 47-yr-old man diagnosed with relapsed diffuse large B cell lymphoma. The bone marrow study showed only erythroid hypoplasia without the evidence of bone marrow involvement with lymphoma cells, thus PRCA was suggested. However, parvovirus infection was excluded as a potential cause of PRCA because of negative IgM anti-parvovirus B19 antibody and negative parvovirus PCR in the serum. Latent Epstein-Barr virus (EBV) infection of bone marrow was suggested by in situ hybridization with EBV-encoded small RNA (EBER) that showed a strong positive expression in bone marrow cells. Thus, PRCA was thought to be associated with latent EBV infection in bone marrow cells. Although the finding of unexplained anemia is a possible predictor of bone marrow involvement with lymphoma cells, PRCA as a result of a viral infection including EBV should be considered in lymphoma patients. This is the first report of the occurrence of PRCA associated with latent EBV infection in a patient with non-Hodgkin's lymphoma.
