%0 Journal Article
%T Reactivation of Epstein¨CBarr Virus Presenting as Massive Splenomegaly after Initiation of Golimumab Treatment
%A Dvir
%A Kathrin
%A Febres-Aldana
%A Anthony J.
%A Febres-Aldana
%A Christopher A.
%A Galarza-Fortuna
%A Gliceida
%A Medina
%A Ana M.
%A Schwartz
%A Michael
%A Sriganeshan
%A Vathany
%J -
%D 2020
%R https://doi.org/10.1155/2020/3641813
%X Epstein¨CBarr virus infection is most commonly asymptomatic in the acute setting, where the end result of infection is the adoption of a viral latency phenotype. The virus can reactivate later in life leading to the abnormal proliferation of the infected B, T, or NK cells. Hereby, we report a 71-year-old female with seronegative rheumatoid arthritis who presented with massive splenomegaly, pancytopenia, and positivization of antibodies against double-stranded deoxyribonucleic acid (dsDNA) after initiation of the anti-tumor necrosis factor (TNF) golimumab. The diagnosis of EBV-associated lymphoproliferative disorder (LPD) was demonstrated by elevation of the plasmatic EBV viral load. Withdrawal of the anti-TNF and treatment with the anti-CD20 antibody rituximab were able to revert the clinical abnormalities. EBV-associated LPDs are described after initiation of other anti-TNF agents, such as infliximab, but no reports of golimumab-associated EBV LPD are found in the literature. The mechanisms for this occurrence are not clear, but these are known to involve expression of a panel of viral proteins specific to the viral latency phenotypes
%U https://www.hindawi.com/journals/crihem/2020/3641813/