EBV-associated lymphoproliferative disorders misdiagnosed as Crohn's disease.
Epstein-Barr virus (EBV) plays an etiological role in various diseases. EBV-associated lymphoproliferative disorder (LPD) is usually observed in individuals with congenital or acquired immune deficiencies but was also recently reported in non-immunocompromised individuals. Two cases of immunocompetent patients with EBV-associated T-cell LPD of the small bowel and colon who were initially misdiagnosed as Crohn's disease (CD) are reported here. EBV-associated T-cell LPD with primary gastrointestinal tract involvement can manifest as multiple discrete ulcers of the small and/or large bowel that are similar to the lesions found in CD or intestinal tuberculosis. However, when patients have multiple intestinal ulcers that are not typical of CD or intestinal tuberculosis and the clinical course is unusual, clinicians should consider the possibility of EBV-associated LPD that involves the gastrointestinal tract because the treatment strategy and prognosis are completely different.
Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Korea. hkna77@naver.com
Hee Kyong
HK
Na
Byong Duk
BD
Ye
Suk-Kyun
SK
Yang
Dong-Hoon
DH
Yang
Kee Wook
KW
Jung
Kyung Jo
KJ
Kim
Jeong-Sik
JS
Byeon
Seung-Jae
SJ
Myung
Jooryung
J
Huh
Jin-Ho
JH
Kim
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D003108:Colonic Diseases / Q000175:diagnosis*; D003424:Crohn Disease / Q000175:diagnosis* / Q000188:drug therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D003951:Diagnostic Errors; D004317:Doxorubicin / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D004854:Herpesvirus 4, Human; D006801:Humans; D007121:Immunocompetence; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000628:therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D014456:Ulcer / Q000175:diagnosis*; D014750:Vincristine / Q000627:therapeutic use
D003561:Cytarabine; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D011241:Prednisone