FROM SUSPECTED LYMPHOPROLIFERATIVE DISEASE TO EPSTEIN-BARR VIRUS AND HUMAN HERPESVIRUS TYPE 6 INFECTION IN A PEDIATRIC KIDNEY TRANSPLANT PATIENT

Abstract

Post-transplant lymphoproliferative disease (PTLD) is the most common malignancy after solid organ transplantation. Its incidence varies by allograft type, ranging from 1% to 3% in pediatric kidney transplant recipients. PTLD is associated with Epstein-Barr virus (EBV) infection, which induces B-cell proliferation, giving rise to lymphoid tumors. In children, it usually appears within the first two years post-transplant as a rare complication, and the definitive diagnosis is based on histopathological findings. We report the case of a 6-year-old boy who, three months after kidney transplantation, presented with fever and persistent mouth ulcers. Suspecting PTLD, an oral biopsy was performed, confirming EBV and human herpesvirus 6 (HHV-6) infection with negative viral loads in the blood. Immunosuppressive therapy, gamma globulin, and ganciclovir were indicated, with a good clinical response.