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Unusual association of diseases/symptoms
Case report
HTLV-positive adult T-cell leukaemia/lymphoma with Epstein-Barr virus and hepatitis B coinfection
  1. Ayesha Munir1,
  2. Mihir Raval2,
  3. Chunlai Zuo3 and
  4. M Kristina Subik3
  1. 1 Internal Medicine, Albany Medical Center Hospital, Albany, New York, USA
  2. 2 Hematology/Oncology, New York Oncology Hematology PC, Albany, New York, USA
  3. 3 Department of Pathology and Laboratory Medicine, Albany Medical Center Hospital, Albany, New York, USA
  1. Correspondence to Dr Ayesha Munir; ayeshamnr6{at}gmail.com

Abstract

Human T-cell lymphotropic virus (HTLV) is a human oncoretrovirus known to cause adult T-cell leukaemia/lymphoma (ATLL). Coinfection of human T-lymphotropic virus type 1 with Epstein-Barr virus (EBV) results in enhanced expression of the HTLV virus and leads to aggressive organ involvement from T-cell malignancy. It has also been observed that the prevalence of hepatitis B infection has been higher in patients with HTLV ATLL as compared with the general population in certain countries. We describe a case of a 34-year-old man who initially presented with leucocytosis, fatigue and conjunctival erythema. His radiological images revealed significant generalised adenopathy, and his flow cytometry analysis came back positive for CD4-positive T-cell lymphoma. He was subsequently diagnosed with HTLV-positive ATLL. Ultimately the patient was also diagnosed with acute hepatitis B and EBV. We describe a unique case of ATLL with coinfection with two other viruses, the association of which can be of potential prognostic value in guiding the treatment strategies for ATLL.

  • Haematology (incl blood transfusion)
  • Malignant and Benign haematology

https://doi.org/10.1136/bcr-2019-231086

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    Footnotes

    • Contributors AM: first author; worked on the manuscript, along with research on the topic; took care of the patient. MR: involved in the care of the patient; worked on the manuscript. CZ: provided and described the pathology slides of the case. MKS: worked on the description of the pathology slides and provided the figure of the case report.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.