Abstract
Azathioprine induced Epstein-Barr virus positive mucocutaneous ulcer: A case report
Highlights
Epstein-Barr virus positive mucocutaneous ulcer (EBVMUC) is a rare, newly described provisional entity in the 2016 Update of World Health Organization classification of lymphoid neoplasms
Unlike classical Hodgkin’s lymphoma (cHL) most EBVMUC cases show indolent course, reduction in immunosuppression appeared was sufficient for those receiving immunosuppression
In 2010, Dojcinov et al [2] first described EBVMUC in a series of 26 patients associated with immunosuppression, 17 patients had age related immunosenescence, while nine cases had been treated with one or more of the immunosuppressive drugs, these included azathioprine, methotrexate or cyclosporin-A
Summary
Epstein-Barr virus positive mucocutaneous ulcer (EBVMUC) is a rare, newly described provisional entity in the 2016 Update of World Health Organization classification of lymphoid neoplasms [1]. A 70-year-old male, non-smoker and non-drinker, known case of diabetes mellitus and hypertension, was diagnosed with Wegener’s granulomatosis (granulomatosis with polyangiitis) in 2007 He had presented with intractable nosebleed, recurrent sinusitis, anterior uveitis, severe joint pain and laboratory findings of rheumatoid (Rh) factor of 45 IU/ml (normal 15 IU/ml) and c-ANCA (cytoplasmic antineutrophil cytoplasmic antibody) of greater than 200U/ml (normal < 3U/ml). EUA revealed an anal ulcer with a fistula tract formation (Figure 1). This patient’s dose of azathioprine was reduced to 100 mg a day and we are waiting a six-month follow-up.
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