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Massive pericardial effusion due to chronic active Epstein–Barr virus infection successfully treated with PD-1 blockade: A case report

Chronic active Epstein–Barr virus (EBV) infection (CAEBV) is a rare but life-threatening EBV-positive lymphoproliferative disorder. Currently, treatment options for CAEBV are limited. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only way to cure CAEBV. Here, we report a rare...

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Autores principales: Pi, Yubo, Wang, Jingshi, Wang, Zhao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410663/
https://www.ncbi.nlm.nih.gov/pubmed/36042605
http://dx.doi.org/10.1097/MD.0000000000030298
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author Pi, Yubo
Wang, Jingshi
Wang, Zhao
author_facet Pi, Yubo
Wang, Jingshi
Wang, Zhao
author_sort Pi, Yubo
collection PubMed
description Chronic active Epstein–Barr virus (EBV) infection (CAEBV) is a rare but life-threatening EBV-positive lymphoproliferative disorder. Currently, treatment options for CAEBV are limited. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only way to cure CAEBV. Here, we report a rare case of CAEBV manifesting as massive pericardial effusion that was successfully treated with programmed cell death protein-1 (PD-1) blockade immunotherapy. PATIENT CONCERNS: A 36-year-old woman with intermittent chest distress and dyspnea for 8 months was admitted to our center on October 25, 2021. Laboratory tests showed leukocytopenia and elevated liver enzyme levels. Initial echocardiography revealed massive pericardial effusion. DIAGNOSIS: High levels of EBV-DNA were detected in the pericardial fluid by metagenomic next-generation sequencing. The pathological diagnosis of her left inguinal lymph node and skin lesions revealed systemic CAEBV. INTERVENTIONS: The patient received sintilimab injection at a dose of 200 mg every 2 weeks in combined with lenalidomide 10 mg once daily. OUTCOMES: The patient achieved complete resolution of pericardial effusion 5 months after PD-1 blockade immunotherapy without apparent adverse effects. LESSONS: CAEBV is a rare but life-threatening EBV-positive lymphoproliferative disease. We present a rare case of massive pericardial effusion caused by systemic CAEBV, which was successfully treated with sintilimab. This case highlights the promising curative effect of PD-1 blockade immunotherapy in systemic CAEBV, especially for patients not suitable for allo-HSCT.
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spelling pubmed-94106632022-08-26 Massive pericardial effusion due to chronic active Epstein–Barr virus infection successfully treated with PD-1 blockade: A case report Pi, Yubo Wang, Jingshi Wang, Zhao Medicine (Baltimore) Research Article Chronic active Epstein–Barr virus (EBV) infection (CAEBV) is a rare but life-threatening EBV-positive lymphoproliferative disorder. Currently, treatment options for CAEBV are limited. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only way to cure CAEBV. Here, we report a rare case of CAEBV manifesting as massive pericardial effusion that was successfully treated with programmed cell death protein-1 (PD-1) blockade immunotherapy. PATIENT CONCERNS: A 36-year-old woman with intermittent chest distress and dyspnea for 8 months was admitted to our center on October 25, 2021. Laboratory tests showed leukocytopenia and elevated liver enzyme levels. Initial echocardiography revealed massive pericardial effusion. DIAGNOSIS: High levels of EBV-DNA were detected in the pericardial fluid by metagenomic next-generation sequencing. The pathological diagnosis of her left inguinal lymph node and skin lesions revealed systemic CAEBV. INTERVENTIONS: The patient received sintilimab injection at a dose of 200 mg every 2 weeks in combined with lenalidomide 10 mg once daily. OUTCOMES: The patient achieved complete resolution of pericardial effusion 5 months after PD-1 blockade immunotherapy without apparent adverse effects. LESSONS: CAEBV is a rare but life-threatening EBV-positive lymphoproliferative disease. We present a rare case of massive pericardial effusion caused by systemic CAEBV, which was successfully treated with sintilimab. This case highlights the promising curative effect of PD-1 blockade immunotherapy in systemic CAEBV, especially for patients not suitable for allo-HSCT. Lippincott Williams & Wilkins 2022-08-26 /pmc/articles/PMC9410663/ /pubmed/36042605 http://dx.doi.org/10.1097/MD.0000000000030298 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Pi, Yubo
Wang, Jingshi
Wang, Zhao
Massive pericardial effusion due to chronic active Epstein–Barr virus infection successfully treated with PD-1 blockade: A case report
title Massive pericardial effusion due to chronic active Epstein–Barr virus infection successfully treated with PD-1 blockade: A case report
title_full Massive pericardial effusion due to chronic active Epstein–Barr virus infection successfully treated with PD-1 blockade: A case report
title_fullStr Massive pericardial effusion due to chronic active Epstein–Barr virus infection successfully treated with PD-1 blockade: A case report
title_full_unstemmed Massive pericardial effusion due to chronic active Epstein–Barr virus infection successfully treated with PD-1 blockade: A case report
title_short Massive pericardial effusion due to chronic active Epstein–Barr virus infection successfully treated with PD-1 blockade: A case report
title_sort massive pericardial effusion due to chronic active epstein–barr virus infection successfully treated with pd-1 blockade: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410663/
https://www.ncbi.nlm.nih.gov/pubmed/36042605
http://dx.doi.org/10.1097/MD.0000000000030298
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