{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T15:38:01Z","timestamp":1770824281033,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,12,22]],"date-time":"2016-12-22T00:00:00Z","timestamp":1482364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuropathology"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:p>A 75\u2010year\u2010old woman was admitted to our hospital with rapidly deteriorating consciousness disturbance. She had a 7\u2010year history of rheumatoid arthritis (RA), which had been treated with methotrexate (MTX) and prednisolone. Brain T2\u2010weighted MRI showed diffuse high\u2010intensity lesions in the cerebral subcortical and deep white matter, bilateral basal ganglia and thalamus. A cerebrospinal fluid examination revealed elevated protein levels and positive Epstein\u2013Barr virus (EBV) DNA. Human immunodeficiency virus was negative. Brain biopsy showed perivascular lymphocytic infiltration in the parenchyma and meninx with EBV\u2010encoded small RNA (EBER). Since this case did not fulfill the criteria for chronic active EBV infection (CAEBV), she was diagnosed with Epstein\u2013Barr virus (EBV)\u2010associated vasculitis of the central nervous system. High\u2010dose methylprednisolone, acyclovir, ganciclovir and foscarnet were not effective. Although EBV is a causative agent of infectious mononucleosis (IM), lymphomas and nasopharyngeal carcinomas, vasculitic pathology of the central nervous system with EBV reactivation in the elderly is rare. Immunosuppressive drugs such as steroids and MTX are widely used to treat autoimmune disorders, but may exacerbate the reactivation of EBV. This is the first case of biopsy\u2010proven EBV\u2010positive\/HIV\u2010negative vasculitis during the treatment of RA with MTX and steroids. This case indicates that EBV\u2010associated vasculitis needs to be considered as a differential diagnosis of CNS vasculitis.<\/jats:p>","DOI":"10.1111\/neup.12356","type":"journal-article","created":{"date-parts":[[2016,12,22]],"date-time":"2016-12-22T15:33:24Z","timestamp":1482420804000},"page":"259-264","source":"Crossref","is-referenced-by-count":26,"title":["Biopsy\u2010proven case of Epstein\u2013Barr virus (EBV)\u2010associated vasculitis of the central nervous system"],"prefix":"10.1111","volume":"37","author":[{"given":"Kohei","family":"Kano","sequence":"first","affiliation":[{"name":"Division of Neurology, First Department of Internal Medicine Asahikawa Medical University  Asahikawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayuki","family":"Katayama","sequence":"additional","affiliation":[{"name":"Division of Neurology, First Department of Internal Medicine Asahikawa Medical University  Asahikawa 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