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.
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SNYDMAN DR, RUDDERS RA, DAOUST P, SULLIVAN JL, EVANS AS. Infectious Mononucleosis in an Adult Progressing to Fatal lmmunoblastic Lymphoma. Ann Intern Med. 1982;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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