{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T19:01:18Z","timestamp":1780340478201,"version":"3.54.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is a small-vessel vasculitis that damages systemic organs; however, its pathogenesis remains unclear. Epstein\u2013Barr virus (EBV) reactivation has been associated with lymphoproliferative disorders and autoimmune diseases, though its association with AAV is rarely reported. Here, we report a 75-year-old man who presented with fever, muscle stiffness, and limb paresthesia. Laboratory tests revealed eosinophilia and positive myeloperoxidase-antineutrophil cytoplasmic antibody, whereas positron emission tomography\u2013computed tomography demonstrated increased splenic fluorodeoxyglucose uptake. Renal biopsy revealed pauci-immune glomerulonephritis with prominent plasmacytic infiltration, and in situ hybridization confirmed EBV-encoded RNA positivity in infiltrating B cells. The patient was diagnosed with AAV complicated by EBV reactivation. Prednisolone therapy achieved initial improvement, but proteinuria persisted during tapering. Furthermore, we reviewed previously reported cases of small-vessel vasculitis associated with EBV reactivation, most of which occurred in elderly men and presented with glomerulonephritis and atypical features, including plasmacytosis or lymphadenopathy. This case and literature review reveal a potential association between AAV and EBV reactivation. Importantly, clinicians should actively consider EBV reactivation as an underlying contributor and should consider testing circulating EBV-DNA and tissue biopsy with EBV-encoded small ribonucleic acid staining in AAV cases with atypical features, including lymphadenopathy, splenomegaly, plasmacytic infiltration, and eosinophilia.<\/jats:p>","DOI":"10.1093\/mrcr\/rxag037","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T12:17:48Z","timestamp":1778674668000},"source":"Crossref","is-referenced-by-count":0,"title":["Epstein\u2013Barr virus reactivation as a potential underlying contributor to atypical features of microscopic polyangiitis"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8346-9216","authenticated-orcid":false,"given":"Atsuhiko","family":"Sunaga","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Matsushita Memorial Hospital , Moriguchi, Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Sonomura","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Matsushita Memorial Hospital , Moriguchi, Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroya","family":"Adachi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Matsushita Memorial Hospital , Moriguchi, Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hozue","family":"Ehara","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Matsushita Memorial Hospital , Moriguchi, Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Matsushita Memorial Hospital , Moriguchi, Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"2026060114021487900_ref1","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1038\/s41572-020-0204-y","article-title":"ANCA-associated vasculitis","volume":"6","author":"Kitching","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"2026060114021487900_ref2","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1182\/blood.2020005466","article-title":"EBV+ lymphoproliferative diseases: opportunities for leveraging EBV as a therapeutic target","volume":"139","author":"Toner","year":"2022","journal-title":"Blood"},{"key":"2026060114021487900_ref3","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1038\/s41584-024-01167-9","article-title":"Epstein-Barr virus as a potentiator of autoimmune diseases","volume":"20","author":"Robinson","year":"2024","journal-title":"Nat Rev 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