Polyclonal B cell hyperplasia associated with Epstein-Barr virus causing acute renal allograft failure.
Six weeks post cadaver renal transplantation, a patient developed a flu-like illness. Acute renal failure unresponsive to anti-rejection therapy occurred and he died four days later from Pneumocystis carinii pneumonia and Streptococcus viridans septicemia. Autopsy revealed a diffuse polymorphic polyclonal B cell infiltrate occupying most organs, including the allograft. Primary Epstein-Barr Virus (EBV) infection was established by 1) rising anti-EBV antibody titres; 2) the demonstration of EBV nuclear antigen in the infiltrate and 3) the presence of EBV specific DNA sequences in affected tissues. EBV associated polymorphic B cell hyperplasia can mimic rejection and result in acute allograft failure.
D000914:Antibodies, Viral / Q000032:analysis; D001402:B-Lymphocytes / Q000473:pathology; D004273:DNA, Neoplasm / Q000235:genetics; D004279:DNA, Viral / Q000235:genetics; D006084:Graft Rejection; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006801:Humans; D006965:Hyperplasia; D016030:Kidney Transplantation; D008223:Lymphoma / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged
D000914:Antibodies, Viral; D004273:DNA, Neoplasm; D004279:DNA, Viral