DAVID R. SNYDMAN, M.D.; RICHARD A. RUDDERS, M.D.; PHILIP DAOUST, M.D.; JOHN L. SULLIVAN, M.D.; ALFRED S. EVANS, M.D.
We report a case of infectious mononucleosis progressing to fatal immunoblastic lymphoma. The patient, a 44-year-old man who may have had an immunoregulatory defect, failed to have an appropriate T-cell response to his Epstein-Barr (EB) viral infection. His active EB viral infection was manifest by seroconversion of IgM-viral capsid antibody and a greater than four fold rise in IgG-viral capsid antibody. Also, he transmitted his EB viral infection to his wife who became ill 1 month after his death. Clinically the patient's illness was characterized by
waxing and waning lymphadenopathy, persistent fever, diarrhea (similar to that associated with cholera), a coagulopathy, and gastrointestinal bleeding. The patient had pathologic findings of a diffuse immunoblastic lymphoma involving lymph nodes, small bowel, liver, pancreas, kidneys, lungs, and bone marrow. Immunologic cell markers showed the tumor to be polyclonal.
SNYDMAN DR, RUDDERS RA, DAOUST P, SULLIVAN JL, EVANS AS. Infectious Mononucleosis in an Adult Progressing to Fatal lmmunoblastic Lymphoma. Ann Intern Med. ;96:737–742. doi: 10.7326/0003-4819-96-6-737
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Published: Ann Intern Med. 1982;96(6_part_1):737-742.
Hematology/Oncology, Infectious Disease, Leukemia/Lymphoma.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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