1. Post-transplant lymphoproliferative disorders are not associated with IgG4 sclerosing disease
- Author
-
Nadine S. Aguilera, Z. Meriden, H. Bonatti, Stephen L. Cook, Helen P. Cathro, and Grant C. Bullock
- Subjects
Adult ,Male ,Epstein-Barr Virus Infections ,Pathology ,medicine.medical_specialty ,Adolescent ,Lymphoproliferative disorders ,Pilot Projects ,Disease ,medicine.disease_cause ,Virus ,Young Adult ,Postoperative Complications ,Lymphoplasmacytic Infiltrate ,Antigen ,Risk Factors ,hemic and lymphatic diseases ,parasitic diseases ,medicine ,Humans ,Child ,Aged ,Retrospective Studies ,Transplantation ,Scleroderma, Systemic ,business.industry ,Organ Transplantation ,Middle Aged ,medicine.disease ,Epstein–Barr virus ,Lymphoproliferative Disorders ,Post transplant ,surgical procedures, operative ,Infectious Diseases ,Child, Preschool ,Immunoglobulin G ,Etiology ,Female ,business - Abstract
Background Although the majority of post-transplant lymphoproliferative disorder (PTLD) cases are associated with Epstein–Barr virus (EBV), 20–42% of cases are EBV negative (EBV-N). The antigenic stimulus that drives EBV-N PTLD is unknown, but is likely heterogeneous. A common feature of PTLD, regardless of EBV status, is an abnormal polytypic lymphoplasmacytic infiltrate. Immunglobulin-G4 (IgG4) syndrome is also characterized by a polytypic lymphoplasmacytic infiltrate with a predominance of IgG4-positive (IgG4-P) plasma cells. Methods We investigated the possibility of an association between EBV-N PTLD and IgG4 syndrome. Of 33 evaluated PTLD cases, 9 (27%) were EBV-N. EBV-N PTLD cases showed longer transplantation-to-diagnosis times than EBV-positive cases. Results A single patient had a preceding benign duodenal biopsy with focally prominent IgG4-P plasma cells; however, no clinical data supported IgG4 syndrome, precluding an association between IgG4 syndrome and subsequent EBV-N PTLD in this patient. Conclusion As none of 29 evaluable cases of PTLD (including all 9 EBV-N cases) were associated with an increase in IgG4-P plasma cells, IgG4 syndrome does not appear to play a role in the etiology of EBV-N PTLD. The significance of these findings and the current understanding of the etiology of EBV-N PTLD are discussed.
- Published
- 2014