Recurrent Enteritis Associated with Epstein-Barr Virus-positive CD4⁺ T-cell Lymphoproliferative Disorder after Autologous Stem Cell Transplantation

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We encountered a patient with multiple myeloma treated with autologous hematopoietic stem cell transplantation (HSCT) who developed repeated episodes of enteritis but regressed spontaneously. An endoscopic examination revealed no abnormalities, but biopsy specimens showed massive infiltration of CD4⁺ and Epstein-Barr encoding region (EBER⁺) abnormal lymphocytes in which a high copy number of Epstein Barr virus (EBV) genomes was detected by quantitative polymerase chain reaction (qPCR). EBV infection was exclusively detected in CD4⁺ T-cells, leading to a diagnosis of EBV-positive CD4⁺ T-cell lymphoproliferative disorder (LPD). This case suggests that an immediate biopsy and examinations, including qPCR for EBV DNA, should be considered for patients with recurrent enteritis after autologous HSCT, regardless of endoscopic findings.