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EBV-associated mucocutaneous ulcer, a rare cause of a frequent problem.
Journal article

EBV-associated mucocutaneous ulcer, a rare cause of a frequent problem.

  • Hess GF Clarunis, University Center for Gastrointestinal and Liver Disease, St. Clara Hospital and University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland.
  • Menter T Institute of Pathology, University Hospital Basel, Schönbeinstrasse 40, CH-4056 Basel, Switzerland.
  • Boll D Department of Radiology and Nuclear Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
  • Steiger J Transplantationimmunology and Nephrology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
  • von Strauss Und Torney M Clarunis, University Center for Gastrointestinal and Liver Disease, St. Clara Hospital and University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland.
  • 2020-04-14
Published in:
  • Journal of surgical case reports. - 2020
English This report presents a 74-year-old renal transplant patient suffering of polymorphic-post-transplant-associated lymphoproliferative disease (P-PTLD) within an Eppstein-Barr Virus (EBV) associated mucocutaneous rectal ulcer (MCU). He was initially treated by stapled hemorrhoidopexy for a symptomatic grade III hemorrhoidal prolapse refractory to conservative treatment and rubber band ligations. This leads to severe urge, frequency and stool fragmentation. The symptoms were investigated with a number of interventions until a proctoscopy with biopsies finally revealed the diagnosis. The patient had triple therapy of tacrolimus, mycophenolate mofetil and prednisone initially after transplant several years ago with recent reduction to mycophenolate. The MCU was successfully treated with Retuximab and there was no sign of relaps after 6 months. As EBV-associated PTLD is a well known complication after renal transplant, rectum-MCU seems a rare and only recently described subform of this disease that should be excluded in case of ulcerating lesions in immunosuppressed patients.
Language
  • English
Open access status
gold
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Persistent URL
https://sonar.ch/global/documents/92734
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