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Antineutrophil Cytoplasmic Autoantibody–Associated Systemic Vasculitis is Associated With Epstein-Barr Virus in the Setting of HIV Infection

Mirsaeidi, Mehdi MD, MPH*; Syed, Fatima MD*; Jaffe, Elaine S. MD

Infectious Diseases in Clinical Practice: January 2013 - Volume 21 - Issue 1 - p 50–53
doi: 10.1097/IPC.0b013e3182601ea1
Case Reports

Introduction Epstein-Barr virus has been a leading candidate as a trigger for several autoimmune diseases. We describe an antineutrophil cytoplasmic autoantibody (ANCA)-associated systemic vasculitis as the initial presenting illness of acquired immunodeficiency syndrome.

Case Report and Results The patient’s condition was diagnosed as ANCA-associated systemic vasculitis in the setting of human immunodeficiency virus infection because of a high level of ANCA level, crescent glomerulonephritis in pathology, and clinical signs and symptoms compatible with systemic vasculitis. He also had human immunodeficiency virus–associated lymphadenopathy with scattered Epstein-Barr virus RNA–positive cells and reactive germinal centers.

Conclusion Epstein-Barr virus genome was found in reactive lymph nodes and, therefore, may be associated with the immunopathogenesis of vasculitis.

From the *Department of Internal Medicine, Providence Hospital, Washington DC and †Department of Pathology; and Microbiology, National Cancer Institute, National Institutes of Health, Bethesda, MD.

Correspondence to: Mehdi Mirsaeidi MD, MPH, Internal Medicine Department, Providence Hospital, 1150 Varnum St, NE, Washington, DC 20017-2180. E-mail:

The authors have no funding or conflicts of interest to disclose.

Dr Mirsaeidi is currently at the Division of Pulmonary Critical Care, Section of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine M/C 719, University of Illinois at Chicago, Chicago, IL.

The manuscript or any closely related paper has not been published in any language journals or submitted to any other publication.

© 2013 Lippincott Williams & Wilkins, Inc.