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Rituximab-Induced Crohn’s Disease-like Colitis Following Treatment for Post-transplant Lymphoproliferative Disorder in Chronic Active Epstein-Barr Virus Infection: A Case Report

Year: 2026

Type: article

Abstract: A man in his 40s with chronic active Epstein-Barr virus infection (CAEBV) underwent allogeneic hematopoietic stem cell transplantation twice and developed post-transplant lymphoproliferative disorder (PTLD), confirmed by Epstein-Barr virus (EBV)-encoded small RNA in situ hybridization. Rituximab treatment achieved complete EBV clearance. However, he subsequently developed longitudinal colonic ulcers despite negative EBV RNA staining and undetectable whole-blood EBV DNA. The endoscopic findings suggested Crohn's disease-like colitis. Patients with graft-versus-host disease (GVHD), recurrent PTLD, cytomegalovirus enteritis, or vasculitis were excluded. Treatment with an infliximab biosimilar induced clinical and endoscopic remission. This case highlights rituximab-associated Crohn's colitis as a rare but important complication.

Source: Internal Medicine

DOI: 10.2169/internalmedicine.7794-26

Authors: Kanako Higaki, Makoto Okabe, Rika Shimizu, Takashi Fuyuno, Yusuke Onoyama, Mio Namikawa, Hiroki Kitamoto, Seiya Bamba, Noriyoshi Yoshinaga, Junya Kanda, Hiroshi Seno

Institutions: Kyoto University, Kobe Medical Center, Kobe City Medical Center General Hospital

Language: English

Topic: Inflammatory Bowel Disease

Subfield: Genetics

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7214629672

FWCI: 4.047

Cites:

Cited by: 1

Related to: 10