Reminder of important clinical lesson
Post-transplant lymphoproliferative disorder in an adolescent masquerading as a complicated primary EBV infection
1 Royal College of Surgeons in Ireland, Medicine, 123 St. Stephen’s Green, Dublin 2, Ireland
2 IWK Health Centre, Pediatrics, 5850 University Avenue, Halifax, Nova Scotia, B3K 6R8, Canada
3 IWK Health Centre, ENT, 5850 University Avenue, Halifax, Nova Scotia, B3K 6R8, Canada
Correspondence to:
Conrad Vincent Fernandez, conrad.fernandez{at}iwk.nshealth.ca
This report describes an adolescent girl with primary Epstein–Barr virus (EBV) infection in the setting of intensive immunosuppression for a cardiac transplant. She went on to develop progressive pain, weight loss and night sweats with necrosis of the tonsils over 8 weeks. The clinical impression was initially that of a complicated tonsillitis secondary to immune dysfunction. Biopsy 2 months after first presentation demonstrated diffuse B cell lymphoma consistent with post-transplant lymphoproliferative disorder (PTLD). We present this case to highlight the need for a high degree of clinical suspicion for PTLD in a population of patients who commonly experience primary exposure to EBV.
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