Case Report: A diagnostic chameleon of EBV-associated immune dysregulation: HLH unmasking multiple myeloma with subsequent emergence of aggressive B-cell lymphoma - Takeaways - MDSpire

Case Report: A diagnostic chameleon of EBV-associated immune dysregulation: HLH unmasking multiple myeloma with subsequent emergence of aggressive B-cell lymphoma

  • By

  • Yang Dai

  • Luocheng Zhang

  • Xushu Zhong

  • Jinbing Zhu

  • Ailin Zhao

  • June 4, 2026

  • 0 min

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  • 1

    HLH is a severe hyper-inflammatory syndrome often triggered by infections, autoimmune diseases, or malignancies, with EBV being a common infectious cause.

  • 2

    This case presents a 70-year-old woman whose HLH was the initial manifestation of multiple myeloma, highlighting the rarity of this association.

  • 3

    Despite achieving remission of both HLH and multiple myeloma, HLH relapsed due to persistent EBV viremia, demonstrating the challenges of EBV-related immune dysregulation.

  • 4

    The patient's aggressive B-cell lymphoma was diagnosed primarily through bone marrow findings, underscoring the limitations of tissue biopsy in such cases.

  • 5

    The patient ultimately succumbed to multi-organ failure following severe chemotherapy-related complications, illustrating the therapeutic difficulties in managing EBV-associated HLH.

Original Source(s)

Case Report: A diagnostic chameleon of EBV-associated immune dysregulation: HLH unmasking multiple myeloma with subsequent emergence of aggressive B-cell lymphoma

  • by Yang Dai, Luocheng Zhang, Xushu Zhong, Jinbing Zhu, Ailin Zhao

  • June 4, 2026

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