Epstein-Barr Virus-Positive Mucocutaneous Ulcer With Medication-Related Osteonecrosis of the Jaw Arising in the Mandible of a Rheumatoid Arthritis Patient: A Case Report

This study presents a rare case of an Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) co-existing with medication-related osteonecrosis of the jaw (MRONJ) in the mandible of a 54-year-old Japanese man who complained of painful swelling of the left mandibular gingiva over the past three mont...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-05, Vol.16 (5), p.e61280
Main Authors: Kanno, Naomi I, Ito, Takashi, Takaoka, Shohei, Yamagata, Kenji, Bukawa, Hiroki
Format: Article
Language:English
Subjects:
Autoimmune diseases
Biopsy
Case reports
Classification
Drug withdrawal
Epstein-Barr virus
HIV
Human immunodeficiency virus
Iatrogenesis
Immune system
Infections
Lymphatic diseases
Lymphocytes
Lymphoma
Monoclonal antibodies
Necrosis
Osteoporosis
Patients
Remission (Medicine)
Rheumatoid arthritis
Surgery
Ulcers
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Summary:This study presents a rare case of an Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) co-existing with medication-related osteonecrosis of the jaw (MRONJ) in the mandible of a 54-year-old Japanese man who complained of painful swelling of the left mandibular gingiva over the past three months. The patient had a history of methotrexate (MTX) and bisphosphonates (BPs) use. Intraoral examination revealed a 35 mm large ulcerative lesion with marginal gingival swelling and bone exposure on the left side of the mandible. A biopsy was performed, confirming the diagnosis of EBVMCU with MRONJ. Due to the enlargement of the bone exposure, marginal resection of the mandible was performed under general anesthesia as a treatment for residual MRONJ. At the two-year follow-up, no evidence of recurrence was observed.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.61280