Relapsing EBV encephalitis in a renal transplant recipient.
Joshua A Stone1, Bettina M Knoll2, Dimitrios Farmakiotis3
1Department of Neurology, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, RI, United States.
Idcases
|October 13, 2017
Summary
This case study shows that valganciclovir may effectively treat relapsing Epstein-Barr virus (EBV) encephalitis in organ transplant patients, alongside reduced immunosuppression. Long-term follow-up is crucial for managing this rare complication.
Area of Science:
- Virology
- Immunology
- Neurology
Background:
- Epstein-Barr virus (EBV) poses risks in solid organ transplant recipients, including CNS infections and PTLD.
- Management typically involves reducing immunosuppression, but antiviral roles are debated due to latent virus.
- EBV encephalitis can present uniquely, even in seronegative recipients.
Purpose of the Study:
- To report a case of relapsing EBV encephalitis in a renal transplant recipient.
- To evaluate the efficacy of antiviral therapy (valganciclovir) in this context.
- To emphasize the importance of a structured, multidisciplinary approach to EBV CNS syndromes.
Main Methods:
- Case report of a donor-positive, EBV-negative renal transplant recipient.
- Clinical presentation and management of relapsing EBV encephalitis.
- Response assessment to valganciclovir and immunosuppression reduction.
Main Results:
- The patient experienced relapsing EBV encephalitis.
- Treatment with valganciclovir, combined with reduced immunosuppression, led to a positive response.
- This suggests a potential role for antivirals in managing EBV encephalitis.
Conclusions:
- Antiviral treatment, such as valganciclovir, can be a valuable adjunct in managing EBV encephalitis.
- A systematic approach and long-term, multidisciplinary follow-up are essential for these patients.
- This case challenges the notion that antivirals are ineffective against EBV CNS disease.
Keywords:
AcyclovirEBVEncephalitisEpstein-Barr virusGanciclovirTransplantationValacyclovirValganciclovirMore Related Videos
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