Skip to content
DraconiticResearch
Search Sources API
203,203 studies31 sourcesUpdated 24 min ago
Peer-reviewedCC BYFrontiers in immunology

Case Report: Relapse of SLE associated with EBV infection in a patient after CAR-T cell therapy: a clinical case

  • Ping Zeng1
  • Qi Ren2
  • Xianfei Gao2
  • Wei Xian2
  • Pui Y. Lee3
  • Feng Li2
  • Caihong Xu2
  • Mingqi Zhao2
  • Wenhao Zhou2
  1. 1Zunyi Medical University , , ,
  2. 2Department of Pediatric, Allergy Immune & Rheumatology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University Guangdong Provincial Clinical Research Center for Child Health , ,
  3. 3Division of Immunology, Harvard Medical School , , ,
Read full textPDFDOICite

Abstract

We present the case of a 13-year-old boy with refractory systemic lupus erythematosus (SLE) who achieved drug-free remission after anti-CD19 CAR-T cell therapy, but subsequently experienced Epstein–Barr virus (EBV) reactivation on day 142 after CAR T-cell infusion and peak EBV load was 24,400 IU/mL with a severe drop in platelets to 8×10 ⁹ /L, which leading to relapse of SLE and manifestations of chronic active EBV disease (CAEBVD). The whole exogenous gene testing found X chromosome Xp22.33q28 region (chrX: 200855-155239820) a duplicate of about 155.04Mbp,which is associated with the development of Klinefelter syndrome (KS).The temporal association between EBV resurgence and SLE flare suggests that CAR-T-induced immunosuppression with some genetic background may permit EBV reactivation, which can be associated with the return of autoimmunity. This case highlights the need for vigilant monitoring for opportunistic infections and genetic background, particularly EBV, after CAR-T therapy for autoimmune diseases, as they may contribute to disease relapse.

Related

  1. An Active Cytomegalovirus Infection and Epstein-Barr Virus Reactivation Complicated by Cytomegalovirus Meningitis and Virus-Associated Hemophagocytic Lymphohistiocytosis during Methotrexate and Upadacitinib Therapy in a Patient with Rheumatoid Arthritis
    Kazuki Tomiyama, Soma Fukami, Toshitaka Yukishima +2
    Internal MedicinePeer-reviewedCC BY-NC-NDFull textEpidemiology & public healthJ-STAGE
  2. Clinical and Biological Correlates of Resistance and Relapse After CD19-Directed CAR T-Cell Therapy in Large B-Cell Lymphoma: A Structured Narrative Review
    Jean Silva de Souza Resende, Igor Samesima Giner, Maria Gabriela Custodio de Figueiredo +3
    CancersPeer-reviewedCC BY 4.0Full textOncologyCrossrefEurope PMC
  3. Clinical outcomes after relapse during rituximab-based maintenance in ANCA-associated vasculitis: A single-center retrospective cohort study
    Makoto Yamaguchi, Hirokazu Sugiyama, Hiroshi Kinashi +8
    PLOS OnePeer-reviewedCC BY 4.0Full textImmunologyPharmacology & toxicologyPLOS
  4. Cutaneous infection caused by Mycobacterium szulgai associated with biologic therapy
    Bárbara Messias Pereira, Bianca Miyazawa, Cássio Rafael Moreira +3
    Anais Brasileiros de DermatologiaPeer-reviewedCC BYFull textEpidemiology & public healthDOAJ
  5. Granulomatous Interstitial Nephritis Associated With Adalimumab Therapy in a Patient With Rheumatoid Arthritis: A Case Report
    Naif Alghamdi
    CureusPeer-reviewedCC BYFull textGeneral medicineEurope PMC

Cite

BibTeXRIS
BibTeX
@article{zeng2026case,
  title = {{Case Report: Relapse of SLE associated with EBV infection in a patient after CAR-T cell therapy: a clinical case}},
  author = {Ping Zeng and Qi Ren and Xianfei Gao and Wei Xian and Pui Y. Lee and Feng Li and Caihong Xu and Mingqi Zhao and Wenhao Zhou},
  journal = {Frontiers in immunology},
  year = {2026},
  month = sep,
  doi = {10.3389/fimmu.2026.1956166},
  url = {https://europepmc.org/article/PMC/PMC13661498},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Case Report: Relapse of SLE associated with EBV infection in a patient after CAR-T cell therapy: a clinical case
AU  - Ping Zeng
AU  - Qi Ren
AU  - Xianfei Gao
AU  - Wei Xian
AU  - Pui Y. Lee
AU  - Feng Li
AU  - Caihong Xu
AU  - Mingqi Zhao
AU  - Wenhao Zhou
PY  - 2026
DA  - 2026/09/30
JO  - Frontiers in immunology
DO  - 10.3389/fimmu.2026.1956166
UR  - https://europepmc.org/article/PMC/PMC13661498
AB  - We present the case of a 13-year-old boy with refractory systemic lupus erythematosus (SLE) who achieved drug-free remission after anti-CD19 CAR-T cell therapy, but subsequently experienced Epstein–Barr virus (EBV) reactivation on day 142 after CAR T-cell infusion and peak EBV load was 24,400 IU/mL with a severe drop in platelets to 8×10 ⁹ /L, which leading to relapse of SLE and manifestations of chronic active EBV disease (CAEBVD). The whole exogenous gene testing found X chromosome Xp22.33q28 region (chrX: 200855-155239820) a duplicate of about 155.04Mbp,which is associated with the development of Klinefelter syndrome (KS).The temporal association between EBV resurgence and SLE flare suggests that CAR-T-induced immunosuppression with some genetic background may permit EBV reactivation, which can be associated with the return of autoimmunity. This case highlights the need for vigilant monitoring for opportunistic infections and genetic background, particularly EBV, after CAR-T therapy for autoimmune diseases, as they may contribute to disease relapse.
SN  - 1664-3224
ER  -