Evidence map›Paper›PMID 28864556›Full record

ArticleBMJ case reports2017

Massive splenomegaly due to concurrent primary Epstein-Barr virus and cytomegalovirus infection in a patient on adalimumab.

Barathy Rani Ramasamy, Patrick Charles, Douglas Johnson, Albert Frauman

Open access · bronzeAbstract readCase Reports
In one paragraph

Article in BMJ case reports, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Barathy Rani RamasamyDepartment of General Medicine, Austin Health, Heidelberg, Victoria, Australia.
Patrick CharlesDepartment of General Medicine, Austin Health, Heidelberg, Victoria, Australia.
Douglas JohnsonDepartment of General Medicine, Austin Health, Heidelberg, Victoria, Australia.
Albert FraumanDepartment of Clinical Pharmacology and Therapeutics, Austin Health, Heidelberg, Victoria, Australia.
Austin Health · AUCabrini Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A 32-year-old man who was receiving adalimumab for seronegative rheumatoid arthritis presented with a 4-week history of fever, night sweats, fatigue, myalgias and diarrhoea. On examination, he had obvious splenomegaly but no lymphadenopathy or pharyngitis. Full blood count revealed mild neutropenia and significant lymphocytosis, with a blood film showing atypical lymphocytes. Liver function tests were mildly deranged with a mixed hepatitic and obstructive pattern. Ultrasound confirmed massive splenomegaly with a span of 21 cm in the long axis. Serological tests confirmed the presence of both primary Epstein-Barr virus and cytomegalovirus infections. The patient had his adalimumab withheld, was treated with supportive measures and improved over a period of 8 weeks. He remained well 5 months after the onset of illness with complete normalisation of blood count and a resolution of the splenomegaly.

Indexed as

AdalimumabAdultAntirheumatic AgentsArthritis, RheumatoidCytomegalovirusCytomegalovirus InfectionsDiagnosis, DifferentialEpstein-Barr Virus InfectionsHerpesvirus 4, HumanHumansMaleSplenomegalyTreatment OutcomeUltrasonographyAdalimumabAntirheumatic AgentsInfectious diseasesrheumatoid arthritisunwanted effects / adverse reactions

Identifiers

PMID28864556
PMCPMC5589034
OpenAlexW2752033468

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.