Reactivation of Epstein–Barr Virus Presenting as Massive Splenomegaly after Initiation of Golimumab Treatment

Figure 3

Flow cytometry (a) and B-cell immunoglobulin gene rearrangement studies (b) demonstrating the clonal nature of the golimumab-induced lymphoproliferative disorder. An abnormal population of B cells (CD-45+, CD-19+) with a dim expression of surface kappa light chain and negative for lambda light chain. B electropherograms of fluorescently labeled PCR products detected by capillary gel electrophoresis showing polyclonality, Gaussian distribution of products, using the BIOMED-2 primer sets IGH FR 1, FR2, FR3, IGK VJ, and IGK VKde. Two broad dominant peaks (234.06 bp and 285.08 bp) were identified with the IGK VKde primer set, which targets the deleting element of the kappa light chain. This result is consistent with the presence of two B-cell clones.

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(b)