case_images: PMC6011099_01
case_images: Axial T2-FLAIR MRI image demonstrating subcortical white matter hyperintensities most prominent within the frontal lobes. Image is courtesy of Dr. Jane Congeni.
case_images: CRII2018-3705376.001.jpg
case_images: PMC6011099_01_CRII2018-3705376.001.jpg
case_images: fig1
case_images: T2 FLAIR sequence, mostly in the frontal lobes and scattered throughout the subcortical white matter (Figure 1). The lesions remained unchanged on repeat MRI at 2 weeks and again at 4 months following presentation, suggesting that these lesions may be consistent with glial scars without acute inflammation of the brain.
case_images: EBV copies remained at nearly 1000 per mL in peripheral blood after a 2-week treatment combination of IVIG and antivirals. EBV copies were reduced drastically with the first dose of rituximab and became undetectable following the second dose.
case_images: CRII2018-3705376.002.jpg
case_images: PMC6011099_01_CRII2018-3705376.002.jpg
case_images: fig2
case_images: Five days after the second rituximab infusion CD19+ and CD20+ lymphocytes and EBV PCR were found to be absent in the blood and remained absent for 5 months, at which time hematopoietic stem cell transplant (HSCT) was performed (Table 1 and Figure 2).