Epstein-Barr virus encephalitis in a patient with rheumatoid arthritis
Epstein-Barr virus encephalitis in a patient with rheumatoid arthritis
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类风湿性关节炎患者的 Epstein-Barr 病毒脑炎
DOI：
10.1093/mrcr/rxab045
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发表时间：
2022
影响因子：
0.8
通讯作者：
Sato Kojiro
中科院分区：
文献类型：
--
作者：
Nakamura Jun;Yanagida Mai;Saito Keisuke;Kamata Yasuyuki;Nagashima Takao;Iwamoto Masahiro;Sato Takeo;Sato Kojiro
53岁女性，6年类风湿关节炎（RA）病史，表现为咽部疼痛、发热和精神状态改变。患者接受甲氨蝶呤（MTX） 12 mg/周，巴西替尼4 mg/天，他克莫司2 mg/天的治疗。脑磁共振成像显示脑白质、基底节区、脑干和右脑半球弥漫性高强度病变。由于脑脊液和血清中EBV- dna水平升高，她被诊断为EBV脑炎。虽然mtx相关的淋巴细胞增生性疾病是众所周知的RA患者并发症，但EBV脑炎需要对这类接受多种有效免疫抑制剂治疗的患者进行密切关注。
A 53-year-old woman with a 6-year history of rheumatoid arthritis (RA) presented with pharyngeal pain, fever, and altered mental status. The patient had been treated with methotrexate (MTX) 12 mg/week, baricitinib 4 mg/day, and tacrolimus 2 mg/day. Magnetic resonance imaging of the brain revealed diffuse high-intensity lesions in the cerebral white matter, basal ganglia, brainstem, and right cerebellar hemisphere. She was diagnosed with Epstein-Barr virus (EBV) encephalitis due to elevated levels of EBV-DNA in the cerebrospinal fluid and serum. Although MTX-associated lymphoproliferative disorders are well-known complications in patients with RA, EBV encephalitis requires careful attention for such patients undergoing treatment with multiple potent immunosuppressants.