Persistent anemia in a patient with diffuse large B cell lymphoma: Pure red cell aplasia associated with latent Epstein-Barr virus infection in bone marrow

Hwa Jung Sung, Jin Kim Seok, Ji Hye Lee, Goeun Lee, Kyung A. Lee, Chul Won Choi, Byung Soo Kim, Jun Suk Kim

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Abstract

We report a case of pure red cell aplasia (PRCA), which was initially suspected as a result of bone marrow involvement of diffuse large B cell lymphoma. Persistent anemia without an obvious cause was observed in a 47-yr-old man diagnosed with relapsed diffuse large B cell lymphoma. The bone marrow study showed only erythroid hypoplasia without the evidence of bone marrow involvement with lymphoma cells, thus PRCA was suggested. However, parvovirus infection was excluded as a potential cause of PRCA because of negative IgM anti-parvovirus B19 antibody and negative parvovirus PCR in the serum. Latent Epstein-Barr virus (EBV) infection of bone marrow was suggested by in situ hybridization with EBV-encoded small RNA (EBER) that showed a strong positive expression in bone marrow cells. Thus, PRCA was thought to be associated with latent EBV infection in bone marrow cells. Although the finding of unexplained anemia is a possible predictor of bone marrow involvement with lymphoma cells, PRCA as a result of a viral infection including EBV should be considered in lymphoma patients. This is the first report of the occurrence of PRCA associated with latent EBV infection in a patient with non-Hodgkin's lymphoma.

Original languageEnglish
JournalJournal of Korean Medical Science
Volume22
Issue numberSUPPL.
Publication statusPublished - 2007 Sep 1

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Pure Red-Cell Aplasia
Epstein-Barr Virus Infections
Lymphoma, Large B-Cell, Diffuse
Anemia
Bone Marrow
Lymphoma
Parvovirus
Human Herpesvirus 4
Bone Marrow Cells
Parvoviridae Infections
Virus Diseases
Non-Hodgkin's Lymphoma
In Situ Hybridization
RNA
Polymerase Chain Reaction
Antibodies
Serum

Keywords

  • Epstein-Barr virus
  • Lymphoma
  • Red-cell aplasia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Persistent anemia in a patient with diffuse large B cell lymphoma : Pure red cell aplasia associated with latent Epstein-Barr virus infection in bone marrow. / Sung, Hwa Jung; Seok, Jin Kim; Lee, Ji Hye; Lee, Goeun; Lee, Kyung A.; Choi, Chul Won; Kim, Byung Soo; Kim, Jun Suk.

In: Journal of Korean Medical Science, Vol. 22, No. SUPPL., 01.09.2007.

Research output: Contribution to journalArticle

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