Diagnosis by polymerase chain reaction of ocular posttransplant lymphoproliferative disorder after pediatric renal transplantation.
OBJECTIVE
To report diagnosis by polymerase chain reaction of intraocular posttransplant lymphoproliferative disorder in a pediatric renal transplant patient.


METHODS
Observational case report.


METHODS
Retrospective review.


RESULTS
An 11-year-old girl developed infectious mononucleosis 15 months after renal transplantation for focal segmental sclerosis. Papillitis and hypopyon uveitis developed 8 months later, followed by iris nodules. Diagnosis of intraocular posttransplant lymphoproliferative disorder was made by polymerase chain reaction of aqueous humor for Epstein-Barr virus and confirmed by histopathology of an iris biopsy specimen. Infiltrating iris lymphocytes in the biopsy specimen were positive for Epstein-Barr DNA. Polymerase chain reaction also revealed gene rearrangement of the variable region of the heavy immunoglobulin chain, consistent with a monoclonal B-lymphocyte population. Iris nodules resolved with reduction in immunosuppressive medication.


CONCLUSIONS
Polymerase chain reaction for Epstein-Barr virus may be helpful in diagnosis of intraocular posttransplant lymphoproliferative disorder.
Al-Attar
Luma
L
Department of Ophthalmology, University of Miami School of Medicine, Bascom Palmer Eye Institute, Miami, Florida 33136, USA.
Berrocal
Audina
A
Warman
Roberto
R
Dubovy
Sander
S
Paredes
Ana
A
Chan
Chi-Chao
CC
Davis
Janet
J
D001082:Aqueous Humor / Q000821:virology; D002648:Child; D004279:DNA, Viral / Q000032:analysis; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000821:virology*; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000821:virology*; D005260:Female; D015321:Gene Rearrangement; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007135:Immunoglobulin Variable Region / Q000235:genetics; D007499:Iris Diseases / Q000175:diagnosis / Q000821:virology; D016030:Kidney Transplantation; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000821:virology*; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications; D012189:Retrospective Studies
D004279:DNA, Viral; D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region