A 13-year-old boy has been admitted to the hospital after suffering from fever and fatigue for the past week. The patient had a cadaveric renal transplant for glomerulonephritis, and his immunosuppressive medication regimen was increased a month ago due to early signs of rejection. The temperature is 37.7 degrees Celsius (99.9 F). The heart and lung exams are unremarkable. The liver is slightly enlarged, and the spleen tip can be felt. Adenopathy is present in the bilateral inguinal and axillary regions. A complete blood count reveals that the patient has mild leukopenia. The image below depicts histopathology findings from a biopsy of one of the enlarged lymph nodes. Which of the following is the most likely cause of this patient's presentation?

Question

A 13-year-old boy has been admitted to the hospital after suffering from fever and fatigue for the past week. The patient had a cadaveric renal transplant for glomerulonephritis, and his immunosuppressive medication regimen was increased a month ago due to early signs of rejection. The temperature is 37.7 degrees Celsius (99.9 F). The heart and lung exams are unremarkable. The liver is slightly enlarged, and the spleen tip can be felt. Adenopathy is present in the bilateral inguinal and axillary regions. A complete blood count reveals that the patient has mild leukopenia. The image below depicts histopathology findings from a biopsy of one of the enlarged lymph nodes.  Which of the following is the most likely cause of this patient's presentation?

Quizplus · Accepted Answer

Eductional Objective: Posttransplantation lymphoproliferative disorder occurs in patients who have had a solid-organ or stem cell transplant and are taking immunosuppressive medications at high doses. The majority of cases are caused by Epstein-Barr virus reactivation, which produces viral proteins that stimulate B-cell proliferation and survival. Patients typically exhibit symptoms similar to mononucleosis.

A 13-Year-Old Boy Has Been Admitted to the Hospital After