• Internal medicine · Sep 2024

    Case Reports

    Successful Treatment of Epstein-Barr Virus Reactivation-associated Transverse Myelitis Following Herpes Zoster with Intravenous Rituximab in a Cord Blood Transplant Recipient.

    • Keijiro Sato, Rie Watanabe, Ichiro Ito, Ken-Ich Imadome, Masahiko Sumi, and Hikaru Kobayashi.
    • Department of Hematology, Nagano Red Cross Hospital, Japan.
    • Intern. Med. 2024 Sep 1; 63 (17): 244524502445-2450.

    AbstractThe Epstein-Barr virus (EBV) is associated with many malignancies and autoimmune diseases, including multiple sclerosis. In addition, EBV rarely but occasionally causes central nervous system (CNS) complications. We herein report a case of transverse myelitis (TM) associated with systemic EBV reactivation after herpes zoster infection in a cord blood transplant recipient. Identification of EBV-infected peripheral blood cells revealed a predominance of B cells. Notably, intravenous rituximab ameliorated EBV reactivation and TM. Since the CNS infiltration rate of intravenous rituximab is markedly low, the clinical efficacy of rituximab against TM suggests that EBV reactivation may cause TM via immune-mediated mechanisms.

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