title: EBV-positive diffuse large B-cell lymphoma in a patient with primary Sjögren's syndrome and membranous glomerulonephritis.
abstract: BACKGROUND
  Sjögren's syndrome is a systemic autoimmune disease in which lymphatic cells destroy the salivary and lacrimal glands. Glomerulonephritis is thought to be a rare occurrence in primary Sjögren's syndrome. Furthermore, concurrent glomerular involvement and lymphoma in patients with Sjögren's syndrome has seldom been reported.
  
  
  METHODS
  A 52-year-old woman with primary Sjögren's syndrome developed membranous glomerulonephritis and Epstein-Barr virus-positive diffuse large B-cell lymphoma (DLBCL). She was diagnosed with Sjögren's syndrome based on the dry eyes, dry mouth, positive anti-nuclear antibody test, anti-Ro (SS-A) antibody, salivary gland biopsy, and salivary scintigraphy. Moreover, renal biopsy confirmed the diagnosis of membranous glomerulonephritis. Three months later, her small bowel was perforated with pneumoperitoneum, and the biopsy revealed Epstein-Barr virus-positive DLBCL.
  
  
  CONCLUSIONS
  We observed the first case of primary Sjögren's syndrome associated with Epstein-Barr Virus-positive DLBCL and membranous glomerulonephritis. Because of the possibility of malignancy-associated membranous glomerulonephritis in patients with primary Sjögren's syndrome, we should be careful and examine such patients for hidden malignancy.
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757, South Korea.
authors.forename: Chang Seong
authors.initials: CS
authors.lastname: Kim
authors.forename: Yoo Duk
authors.initials: YD
authors.lastname: Choi
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Choi
authors.forename: Eun Hui
authors.initials: EH
authors.lastname: Bae
authors.forename: Seong Kwon
authors.initials: SK
authors.lastname: Ma
authors.forename: Soo Wan
authors.initials: SW
authors.lastname: Kim
mesh_terms: D005260:Female; D015433:Glomerulonephritis, Membranous / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000150:complications / Q000175:diagnosis* / Q000821:virology