title: Unusual Indolent Course of a Chronic Active Epstein-Barr Virus-Associated Natural Killer Cell Lymphoproliferative Disorder.
abstract: Natural killer (NK) cell lymphoproliferative disorders are uncommon and the Epstein-Barr virus (EBV) plays an important aetiological role in their pathogenesis. We report a 20-year-old male with a chronic active EBV infection associated with a NK cell lymphoproliferative disorder which had an unusual indolent course. He presented to the Sultan Qaboos University Hospital in Muscat, Oman, in December 2011 with a history of intermittent fever and coughing. Examinations revealed generalised lymphadenopathy, hepatosplenomegaly, leukocytosis, transaminitis, diffuse bilateral lung infiltrates and bone marrow lymphocyte involvement. A polymerase chain reaction (PCR) test revealed a high EBV viral load in the peripheral blood cells. The patient received a course of piperacillin-tazobactam for Klebsiella pneumoniae, but no active treatment for the lymphoproliferative disorder. However, his lymphocyte count, serum lactate dehydrogenase and liver enzymes dropped spontaneously. In addition, EBV PCR copies fluctuated and then decreased significantly. He remained clinically asymptomatic over the following four years.
authors.affiliation: Departments of Haematology, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Arwa Z
authors.initials: AZ
authors.lastname: Al-Riyami
authors.affiliation: Departments of Haematology, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Khalil
authors.initials: K
authors.lastname: Al-Farsi
authors.affiliation: Departments of Haematology, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Murtadha
authors.initials: M
authors.lastname: Al-Khabori
authors.affiliation: Departments of Haematology, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Huneini
authors.affiliation: Pathology, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Al-Hadabbi
keywords: Case Report; Epstein-Barr Virus Infections; Lymphoproliferative Disorders; Natural Killer Cell; Oman; Spontaneous Remission