Persistent anemia in a patient with diffuse large B cell lymphoma

Pure red cell aplasia associated with latent Epstein-Barr virus infection in bone marrow

Jung Sung Hwa, Jin Kim Seok, Ji Hye Lee, Goeun Lee, Kyunga Lee, Won Choi Chul, Soo Kim Byung, Suk Kim Jun

Research output: Contribution to journalArticle

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Abstract

We report a case of pure red cell aplasia (PRCA), which was initially suspected as a result of bone marrow involvement of diffuse large B cell lymphoma. Persistent anemia without an obvious cause was observed in a 47-yr-old man diagnosed with relapsed diffuse large B cell lymphoma. The bone marrow study showed only erythroid hypoplasia without the evidence of bone marrow involvement with lymphoma cells, thus PRCA was suggested. However, parvovirus infection was excluded as a potential cause of PRCA because of negative IgM anti-parvovirus B19 antibody and negative parvovirus PCR in the serum. Latent Epstein-Barr virus (EBV) infection of bone marrow was suggested by in situ hybridization with EBV-encoded small RNA (EBER) that showed a strong positive expression in bone marrow cells. Thus, PRCA was thought to be associated with latent EBV infection in bone marrow cells. Although the finding of unexplained anemia is a possible predictor of bone marrow involvement with lymphoma cells, PRCA as a result of a viral infection including EBV should be considered in lymphoma patients. This is the first report of the occurrence of PRCA associated with latent EBV infection in a patient with non-Hodgkin's lymphoma.

Original languageEnglish
JournalJournal of Korean medical science
Volume22
Issue numberSUPPL.
Publication statusPublished - 2007 Sep 1

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Pure Red-Cell Aplasia
Epstein-Barr Virus Infections
Lymphoma, Large B-Cell, Diffuse
Anemia
Bone Marrow
Lymphoma
Parvovirus
Human Herpesvirus 4
Bone Marrow Cells
Parvoviridae Infections
Virus Diseases
Non-Hodgkin's Lymphoma
In Situ Hybridization
RNA
Polymerase Chain Reaction
Antibodies
Serum

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Hwa, Jung Sung ; Seok, Jin Kim ; Lee, Ji Hye ; Lee, Goeun ; Lee, Kyunga ; Chul, Won Choi ; Byung, Soo Kim ; Jun, Suk Kim. / Persistent anemia in a patient with diffuse large B cell lymphoma : Pure red cell aplasia associated with latent Epstein-Barr virus infection in bone marrow. In: Journal of Korean medical science. 2007 ; Vol. 22, No. SUPPL.
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abstract = "We report a case of pure red cell aplasia (PRCA), which was initially suspected as a result of bone marrow involvement of diffuse large B cell lymphoma. Persistent anemia without an obvious cause was observed in a 47-yr-old man diagnosed with relapsed diffuse large B cell lymphoma. The bone marrow study showed only erythroid hypoplasia without the evidence of bone marrow involvement with lymphoma cells, thus PRCA was suggested. However, parvovirus infection was excluded as a potential cause of PRCA because of negative IgM anti-parvovirus B19 antibody and negative parvovirus PCR in the serum. Latent Epstein-Barr virus (EBV) infection of bone marrow was suggested by in situ hybridization with EBV-encoded small RNA (EBER) that showed a strong positive expression in bone marrow cells. Thus, PRCA was thought to be associated with latent EBV infection in bone marrow cells. Although the finding of unexplained anemia is a possible predictor of bone marrow involvement with lymphoma cells, PRCA as a result of a viral infection including EBV should be considered in lymphoma patients. This is the first report of the occurrence of PRCA associated with latent EBV infection in a patient with non-Hodgkin's lymphoma.",
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Persistent anemia in a patient with diffuse large B cell lymphoma : Pure red cell aplasia associated with latent Epstein-Barr virus infection in bone marrow. / Hwa, Jung Sung; Seok, Jin Kim; Lee, Ji Hye; Lee, Goeun; Lee, Kyunga; Chul, Won Choi; Byung, Soo Kim; Jun, Suk Kim.

In: Journal of Korean medical science, Vol. 22, No. SUPPL., 01.09.2007.

Research output: Contribution to journalArticle

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AU - Seok, Jin Kim

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AU - Lee, Goeun

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AU - Jun, Suk Kim

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AB - We report a case of pure red cell aplasia (PRCA), which was initially suspected as a result of bone marrow involvement of diffuse large B cell lymphoma. Persistent anemia without an obvious cause was observed in a 47-yr-old man diagnosed with relapsed diffuse large B cell lymphoma. The bone marrow study showed only erythroid hypoplasia without the evidence of bone marrow involvement with lymphoma cells, thus PRCA was suggested. However, parvovirus infection was excluded as a potential cause of PRCA because of negative IgM anti-parvovirus B19 antibody and negative parvovirus PCR in the serum. Latent Epstein-Barr virus (EBV) infection of bone marrow was suggested by in situ hybridization with EBV-encoded small RNA (EBER) that showed a strong positive expression in bone marrow cells. Thus, PRCA was thought to be associated with latent EBV infection in bone marrow cells. Although the finding of unexplained anemia is a possible predictor of bone marrow involvement with lymphoma cells, PRCA as a result of a viral infection including EBV should be considered in lymphoma patients. This is the first report of the occurrence of PRCA associated with latent EBV infection in a patient with non-Hodgkin's lymphoma.

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