{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:48:30Z","timestamp":1757612910249,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2019,8,10]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>The incidence of Epstein\u2013Barr virus (EBV)associated lymphoproliferative disorders has increased with greater use of immunomodulatory therapies. We present a woman who developed subacute cognitive decline and unilateral weakness while taking long-term mycophenolate mofetil for granulomatosis with polyangiitis; her postmortem brain histopathology confirmed an EBV-driven lymphoproliferative disorder. Clinicians must have a high index of suspicion for EBV-driven lymphoma in people taking long-term immunosuppression who develop new neurological problems. We review the role of mycophenolate mofetil in EBV-driven lymphoproliferative disorders, and discuss checking EBV status in all patients starting immunosuppression and in older people already taking immunosuppression.<\/jats:p>","DOI":"10.1136\/practneurol-2019-002356","type":"journal-article","created":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T17:25:12Z","timestamp":1567099512000},"page":"83-86","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Epstein\u2013Barr virus associated CNS lymphoproliferative disorder after long-term immunosuppression"],"prefix":"10.1136","volume":"20","author":[{"given":"Andrew","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurology, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie R","family":"Bridges","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology, St Georges University Hospitals, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Lloyd","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Barker","sequence":"additional","affiliation":[{"name":"Department of Radiology, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damian R","family":"Wren","sequence":"additional","affiliation":[{"name":"Department of Neurology, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare M","family":"Galtrey","sequence":"additional","affiliation":[{"name":"Department of Neurology, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,8,29]]},"reference":[{"key":"2025090409235318000_20.1.83.1","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1097\/NEN.0000000000000076","article-title":"CNS lymphoma: a practical diagnostic approach","volume":"73","author":"Giannini","year":"2014","journal-title":"J Neuropathol Exp Neurol"},{"key":"2025090409235318000_20.1.83.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08161.x"},{"key":"2025090409235318000_20.1.83.3","doi-asserted-by":"publisher","DOI":"10.1215\/15228517-2007-004"},{"key":"2025090409235318000_20.1.83.4","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24834"},{"key":"2025090409235318000_20.1.83.5","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2334-11-281","article-title":"Clinical characteristics of patients with Epstein Barr virus in cerebrospinal fluid","volume":"11","author":"Martelius","year":"2011","journal-title":"BMC Infect Dis"},{"key":"2025090409235318000_20.1.83.6","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2004.045336"},{"key":"2025090409235318000_20.1.83.7","doi-asserted-by":"crossref","unstructured":"Shannon-Lowe C , Rickinson AB , Bell AI . 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