Mucocutaneous Ulcers in Organ Transplant Recipient: Think Epstein-Barr

Epstein-Barr virus (EBV) drives most posttransplant lymphoproliferative disorders (PTLDs), especially in patients who were EBV-naive before transplantation. EBV is also associated with mucocutaneous and gastrointestinal ulcers (EBV MCU) in immunosuppressed patients.

These authors retrospectively studied seven posttransplant patients with EBV MCU from a cohort of patients with EBV PTLDs (kidney, 5; heart, 1; lung, 1; median age, 61; male:female ratio, 2.5:1). Ulcers were mucocutaneous (lip, oral cavity) in 60% or gastrointestinal. Duration of immunosuppression before ulcer development varied from 0.6 to 13 years. Ulcer biopsy samples showed a background of mixed hematopoietic infiltrate necrosis and Reed-Sternberg–like or large B cells positive for CD20, CD30 or EBV-encoded RNA. No patients had EBV DNA in the blood. Reducing immunosuppression resolved lesions in all patients. In an average 34-month follow-up, no EBV MCUs or PTLDs recurred.

Reviewing Author

Angelica Selim, MD

Disclosures

Grant / Research support NIH/NCI, The Plastic Surgery Foundation

Angelica Selim, MD

Disclosures

Grant / Research support NIH/NCI, The Plastic Surgery Foundation

Mucocutaneous Ulcers in Organ Transplant Recipient: Think Epstein-Barr

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Reviewing Author