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Background <p>Follicular lymphoma (FL) is a common subtype of non-Hodgkin lymphoma (NHL) associated with the t(14;18) translocation. First-line treatment is generally based on anti-CD20 monoclonal antibody-containing immunochemotherapy, and rituximab maintenance may be used in patients who respond to induction therapy. Although maintenance therapy prolongs progression-free survival, it may increase the risk of infection by depleting B cells and impairing humoral immunity. Enteroviral infections are usually mild or self-limited in immunocompetent individuals but can cause severe complications, including chronic encephalitis, in immunocompromised patients, particularly those receiving B-cell-depleting therapies.</p> Case presentation <p>We report the case of a woman diagnosed at 29 years of age with stage IV, grade 3A follicular lymphoma who developed chronic enteroviral encephalitis during rituximab maintenance therapy. After six cycles of R-CHOP, she achieved complete remission and was started on rituximab maintenance every three months. Shortly after the sixth maintenance dose, she presented with confusion and involuntary movements. Diagnostic evaluation, including cerebrospinal fluid RT-PCR, confirmed enterovirus infection.</p> Conclusion <p>Chronic enteroviral encephalitis is a rare but serious complication in immunocompromised patients, particularly those receiving rituximab or other anti-CD20 therapies that deplete B cells and impair humoral immunity.</p>

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Enterovirus Encephalitis Developing After Treatment for Follicular Lymphoma: A Case Report

  • 期刊论文

  • 发表日期：

    2026年7月22日

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  • Mohamad Eid,
  • Eren Toplutaş,
  • Alperen Sezer,
  • Hüseyin Saffet Beköz,
  • Amir Hossein Abedi,
  • Süreyya Yiğit Kaya,
  • Senem Maral,
  • Leylagül Kaynar

摘要

Background

Follicular lymphoma (FL) is a common subtype of non-Hodgkin lymphoma (NHL) associated with the t(14;18) translocation. First-line treatment is generally based on anti-CD20 monoclonal antibody-containing immunochemotherapy, and rituximab maintenance may be used in patients who respond to induction therapy. Although maintenance therapy prolongs progression-free survival, it may increase the risk of infection by depleting B cells and impairing humoral immunity. Enteroviral infections are usually mild or self-limited in immunocompetent individuals but can cause severe complications, including chronic encephalitis, in immunocompromised patients, particularly those receiving B-cell-depleting therapies.

Case presentation

We report the case of a woman diagnosed at 29 years of age with stage IV, grade 3A follicular lymphoma who developed chronic enteroviral encephalitis during rituximab maintenance therapy. After six cycles of R-CHOP, she achieved complete remission and was started on rituximab maintenance every three months. Shortly after the sixth maintenance dose, she presented with confusion and involuntary movements. Diagnostic evaluation, including cerebrospinal fluid RT-PCR, confirmed enterovirus infection.

Conclusion

Chronic enteroviral encephalitis is a rare but serious complication in immunocompromised patients, particularly those receiving rituximab or other anti-CD20 therapies that deplete B cells and impair humoral immunity.