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Kleinman, S., Jhaveri, D., Caimi, P., Cameron, R., Lemonovich, T., Meyerson, H., et al. (2014) A Rare Presentation of EBV(+) Mucocutaneous Ulcer That Led to a Diagnosis of Hypogammaglobulinemia. The Journal of Allergy and Clinical Immunology: In Practice, 2, 810-812.
https://doi.org/10.1016/j.jaip.2014.07.009

has been cited by the following article:

• TITLE: Epstein-Barr Virus Upper Gastrointestinal Tract Mucocutaneous Ulceration in a Renal Transplant Recipient with Leucopenia and Hypogammaglobulinaemia

  AUTHORS: Kalpa Jayanatha, Jonathan Hsiao, Viliami Tutone

  KEYWORDS: Epstein-Barr Virus, Mucocutaneous Ulceration, Renal Transplant, Immunosuppression, Immunodeficiency

  JOURNAL NAME: Case Reports in Clinical Medicine, Vol.11 No.9, September 5, 2022

  ABSTRACT: Epstein-Barr virus (EBV) mucocutaneous ulceration is a rare complication of immunosuppression that results in painful ulceration of the tongue or gingiva, and less commonly, refractory ulceration of the gastrointestinal tract. High clinical suspicion is required, as failure to diagnose EBV mucocutaneous ulceration may result in significant morbidity and mortality. We report the case of a 64-year-old female renal transplant recipient requiring admission to hospital for management of severe oral and epigastric pain. Examination revealed a large, superficial, well-circumscribed ulcer at the base of the tongue. Blood tests suggested a secondary immunodeficiency characterised by mild leucopenia, hypogammaglobulinaemia, and low memory B-cells with normal immunophenotype. Endoscopy revealed four, cratered ulcers in the pre-pyloric region of the stomach. A core biopsy of the tongue ulcer confirmed EBV mucocutaneous ulceration. The patient’s immunosuppression was optimised, which resulted in complete resolution of the tongue and gastric ulcers at eight and twelve weeks of follow-up respectively.