Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorder in a Pediatric Patient

Abstract

It is estimated that approximately 90% of the adult population is infected with the Epstein Barr Virus (EBV). In states of immunosuppression, the disruption in immune regulation can manifest as lymphoproliferative disease that classically presents as a lymphoma. Rarely, EBV-driven lymphoproliferative disease can present as a mucocutaneous ulcer. While this phenomenon is becoming well documented in the adult population, cases affecting pediatric patients are lacking. In this report, we describe a case of a pediatric immunosuppressed patient presenting with an EBV-positive mucocutaneous ulcer. EBV-positive mucocutaneous ulcer in an immunosuppressed patient is an entity within the spectrum of iatrogenic immunodeficiency-associated lymphoproliferative disorders (LPD) which closely resembles the better-categorized post-transplant lymphoproliferative disorder (PTLD). Though the concept of lymphoproliferative disorders in immunosuppressed patients has been well established, this is a unique case in a pediatric patient.