[Pancytopenia and lymph node swelling. Cardinal symptoms of an unusual differential diagnosis].
Identifieur interne : 005F15 ( Main/Exploration ); précédent : 005F14; suivant : 005F16[Pancytopenia and lymph node swelling. Cardinal symptoms of an unusual differential diagnosis].
Auteurs : C. Kahl [Allemagne] ; M. Leith User ; C. Junghanss ; F. Prall ; M. FreundSource :
- Der Internist [ 1432-1289 ] ; 2009.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- complications : Epstein-Barr Virus Infections, Lymphedema, Pancytopenia.
- diagnosis : Epstein-Barr Virus Infections, Lymphedema, Pancytopenia.
- Diagnosis, Differential, Female, Humans.
Abstract
A 47-year-old woman was admitted to our emergency room because of anemia and acute tonsillitis. She reported recurrent fever and a sore throat. Clinical examination and CT scans showed general lymph node swelling and liver enlargement. In the course of the disease she developed pancytopenia with neutropenic fever, pleuropneumonia, and deep vein thrombosis. The histological examination of a lymph node showed a reactive, EBV-associated lymphadenitis. The examination of the bone marrow showed an activated marrow. The diagnosis of an active EBV infection was established with 2 x 10(6)/ml EBV gene copies in the blood. In addition, systemic lupus erythematosus was diagnosed because of the typical autoantibody constellation and clinical findings. The immunohematological examination showed autoantibodies against the three blood cell compartments. Because of the severe pancytopenia as a result of the EBV- and SLE-associated autoantibodies and despite recurrent infections, we initiated immunosuppressive therapy with low-dose corticosteroids. This therapy resulted in normalization of the blood counts. Anitibody levels and the EBV genome levels became negative.
DOI: 10.1007/s00108-008-2279-5
PubMed: 19214464
Affiliations:
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Prall</name></author><author><name sortKey="Freund, M" sort="Freund, M" uniqKey="Freund M" first="M" last="Freund">M. 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Cardinal symptoms of an unusual differential diagnosis].</title><author><name sortKey="Kahl, C" sort="Kahl, C" uniqKey="Kahl C" first="C" last="Kahl">C. Kahl</name><affiliation wicri:level="1"><nlm:affiliation>Abteilung Hämatologie und Onkologie, Klinik und Poliklinik für Innere Medizin, Ernst-Heydemann-Strasse 6, 18055 Rostock. christoph.kahl@med.uni-rostock.de</nlm:affiliation><country wicri:rule="url">Allemagne</country></affiliation></author><author><name sortKey="Leith User, M" sort="Leith User, M" uniqKey="Leith User M" first="M" last="Leith User">M. Leith User</name></author><author><name sortKey="Junghanss, C" sort="Junghanss, C" uniqKey="Junghanss C" first="C" last="Junghanss">C. Junghanss</name></author><author><name sortKey="Prall, F" sort="Prall, F" uniqKey="Prall F" first="F" last="Prall">F. Prall</name></author><author><name sortKey="Freund, M" sort="Freund, M" uniqKey="Freund M" first="M" last="Freund">M. Freund</name></author></analytic><series><title level="j">Der Internist</title><idno type="eISSN">1432-1289</idno><imprint><date when="2009" type="published">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Diagnosis, Differential</term><term>Epstein-Barr Virus Infections (complications)</term><term>Epstein-Barr Virus Infections (diagnosis)</term><term>Female</term><term>Humans</term><term>Lymphedema (complications)</term><term>Lymphedema (diagnosis)</term><term>Pancytopenia (complications)</term><term>Pancytopenia (diagnosis)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Diagnostic différentiel</term><term>Femelle</term><term>Humains</term><term>Infections à virus Epstein-Barr ()</term><term>Infections à virus Epstein-Barr (diagnostic)</term><term>Lymphoedème ()</term><term>Lymphoedème (diagnostic)</term><term>Pancytopénie ()</term><term>Pancytopénie (diagnostic)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Epstein-Barr Virus Infections</term><term>Lymphedema</term><term>Pancytopenia</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Epstein-Barr Virus Infections</term><term>Lymphedema</term><term>Pancytopenia</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à virus Epstein-Barr</term><term>Lymphoedème</term><term>Pancytopénie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Diagnostic différentiel</term><term>Femelle</term><term>Humains</term><term>Infections à virus Epstein-Barr</term><term>Lymphoedème</term><term>Pancytopénie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A 47-year-old woman was admitted to our emergency room because of anemia and acute tonsillitis. She reported recurrent fever and a sore throat. Clinical examination and CT scans showed general lymph node swelling and liver enlargement. In the course of the disease she developed pancytopenia with neutropenic fever, pleuropneumonia, and deep vein thrombosis. The histological examination of a lymph node showed a reactive, EBV-associated lymphadenitis. The examination of the bone marrow showed an activated marrow. The diagnosis of an active EBV infection was established with 2 x 10(6)/ml EBV gene copies in the blood. In addition, systemic lupus erythematosus was diagnosed because of the typical autoantibody constellation and clinical findings. The immunohematological examination showed autoantibodies against the three blood cell compartments. Because of the severe pancytopenia as a result of the EBV- and SLE-associated autoantibodies and despite recurrent infections, we initiated immunosuppressive therapy with low-dose corticosteroids. This therapy resulted in normalization of the blood counts. Anitibody levels and the EBV genome levels became negative.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country></list><tree><noCountry><name sortKey="Freund, M" sort="Freund, M" uniqKey="Freund M" first="M" last="Freund">M. Freund</name><name sortKey="Junghanss, C" sort="Junghanss, C" uniqKey="Junghanss C" first="C" last="Junghanss">C. Junghanss</name><name sortKey="Leith User, M" sort="Leith User, M" uniqKey="Leith User M" first="M" last="Leith User">M. Leith User</name><name sortKey="Prall, F" sort="Prall, F" uniqKey="Prall F" first="F" last="Prall">F. Prall</name></noCountry><country name="Allemagne"><noRegion><name sortKey="Kahl, C" sort="Kahl, C" uniqKey="Kahl C" first="C" last="Kahl">C. Kahl</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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