Unusual Indolent Course of a Chronic Active Epstein-Barr Virus-Associated Natural Killer Cell Lymphoproliferative Disorder
Journal Title: Sultan Qaboos University Medical Journal - Year 2016, Vol 16, Issue 2
Abstract
Natural killer (NK) cell lymphoproliferative disorders are uncommon and the Epstein-Barr virus (EBV) plays an important aetiological role in their pathogenesis. We report a 20-year-old male with a chronic active EBV infection associated with a NK cell lymphoproliferative disorder which had an unusual indolent course. He presented to the Sultan Qaboos University Hospital in Muscat, Oman, in December 2011 with a history of intermittent fever and coughing. Examinations revealed generalised lymphadenopathy, hepatosplenomegaly, leukocytosis, transaminitis, diffuse bilateral lung infltrates and bone marrow lymphocyte involvement. A polymerase chain reaction (PCR) test revealed a high EBV viral load in the peripheral blood cells. Te patient received a course of piperacillin-tazobactam for Klebsiella pneumoniae, but no active treatment for the lymphoproliferative disorder. However, his lymphocyte count, serum lactate dehydrogenase and liver enzymes dropped spontaneously. In addition, EBV PCR copies fluctuated and then decreased signifcantly. He remained clinically asymptomatic over the following four years.
Authors and Affiliations
Arwa Z. Al-Riyami| Departments of Haematology, Sultan Qaboos University Hospital, Muscat, Oman, Khalil Al-Farsi| Departments of Haematology, Sultan Qaboos University Hospital, Muscat, Oman, Murtadha Al-Khabori| Departments of Haematology, Sultan Qaboos University Hospital, Muscat, Oman, Mohammed Al-Huneini| Departments of Haematology, Sultan Qaboos University Hospital, Muscat, Oman, Ibrahim Al-Hadabbi| Departments of Pathology, Sultan Qaboos University Hospital, Muscat, Oman
Keywords
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