Viral Induced Reactive Plasmacytosis

Viral Induced Reactive Plasmacytosis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Viral Induced Reactive Plasmacytosis Aishwarya Bhatnagar, Anamika Joshi, Kailash Chandra Morya, Kailash Kewalia This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3931136/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Plasmacytosis is a condition of increased number of plasma cells in tissues, exudate or blood as a defence mechanism. Transient immune reactions in any infection or autoimmune disorder may present as reactive plasmacytosis that might rarely also manifest as plasma cell mucositis. Reactive plasmacytosis has been reported in several viral infections and has been found to completely disappear within 2 weeks. Complete clinical evaluation, individualised investigation and more specific tests are required to rule out these oral manifestations. Thus, we hereby present an extremely rare condition wherein Human Papilloma Virus (HPV) led to reactive plasmacytosis. Human Papilloma virus Viral induced Oral Warts Reactive Plasmacytosis Squamous papilloma Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Plasmacytosis can be described as a condition characterized by mainly by immense proportions of plasma cell in either tissue, exudates or blood. Reactive plasmacytosis is a transient event based on the reflection of immune reactions and it is seldom found in variety of diseases such as infectious diseases, tumour and autoimmune disorders. [ 1 ] It has been substantiated that various viral infections including Hepatitis A, Epstein-barr, Dengue virus and Parvovirus B 19 are associated with reactive plasmacytosis. [ 2 ] Orally these lesions can be manifested as plasma Cell Mucositis (PCM). A group of HPV are causative of papillary lesions, clinically presenting an intensely erythematous mucosa with papillomatous, cobblestone, nodular, or velvety surface changes. [ 3 ] Symptoms might include dysphagia, oral pain, sore throat, and pharyngitis. [ 4 ] Only close communication between specialists in several disciplines can differentiate the PCM from other neoplastic conditions. Therefore, it is necessary to perform more specific investigations in order to achieve an appropriate diagnosis and obtain better clinical management. [ 5 ] Thus, here we describe a rare case report of a patient that presented with a papillary overgrowth as a manifestation of HPV induced reactive plasmacytosis. Case Description A 32-year-old male patient visited the Department of Oral Medicine and Radiology with a chief complaint of mild pain in the right upper and lower back tooth region from last 5 days. On being asked the patient also reported having mild fever and fatigue 5–7 days back which subsided on its own, but he was not aware of any other finding in the mouth. No history of weight loss, cutaneous lesions, irritation or rashes was reported. Patient gave no history of any deleterious habit or stress. No significant extraoral finding was obtained. On Intraoral examination, a well-defined exophytic overgrowth with whitish papillary projections was observed at the palatal aspect of marginal gingiva with relation to 16, measuring around 1x1.5 cm in dimension. On palpation it was elevated, rough in texture, non-tender and non-scrapable [Figure 1,2]. Based on the clinical appearance and history of the patient a provisional diagnosis of Squamous papilloma or Warts (verruca vulgaris) was given. On further investigation, viral culture revealed presence of viral particles within the nuclei. Excisional biopsy was performed and the specimen obtained was 1.6 x 0.6 x 0.4 cm in dimensions. Histopathologic report [Figure – 3] showed stratified squamous epithelium with pseudo-epitheliomatous hyperplasia and surface keratinization. Sub-epithelium showed dense infiltrate comprising of numerous plasma cells and few lymphocytes. No fungal profile or dysplasia was noted. Radiographic investigations also didn’t reveal any significant finding [Figure – 4]. Based on the investigations, final diagnosis of Warts (HPV) leading to reactive plasmacytosis irt 16 was made. The patient was kept on regular follow-up for 6 months and no recurrence was noted in this time period [Figure − 5]. Discussion Plasmacytosis, that can also be manifested as PCM, is an idiopathic disorder histologically characterized by dense infiltrates of lymphocytes and plasma cells in submucosa as noted in the present case. In the past, this pathology has been reported under various names according to the anatomical structure involved with the component of plasma cells, such as idiopathic plasmacytosis of the gingiva, plasma cell vulvitis, oral papillary plasmacytosis, or mucous membrane plasmacytosis of the upper aerodigestive tract. [ 2 ] The lesions of PCM are usually observed on the mucosal surfaces, gingiva, lips, tongue, buccal mucosa, vulva and penis, epiglottis, and larynx. [ 4 ] In our case it was present on palatal mucosa. The multifactorial mechanism causing proliferation of plasma cells could be considered as a defence response mechanism to the underlying disease processes due to increased release of paracrine growth factors such as cytokines, IL-6 or IL-10. [ 5 ] It has been substantiated that various viral infections including Hepatitis A, Epstein-barr, Dengue and Parvovirus B 19 are associated with reactive plasmacytosis. However, PCM is a rare disease, and its exact etiology is not yet known, it is generally reported in patients’ with previous history of immunologically mediated disease like Sjögren syndrome or possible autoimmune hepatitis. It is not noticed in all these cases and also no single disease is consistently associated. [ 4 ] No evidence of malignant transformation of such lesions has been reported in literatures previously and thus its considered to be a benign condition of adults. Clinically it presents as an intensely erythematous mucosa with papillomatous, nodular, cobblestone or velvety changes on the mucosal surface [ 3 ] . In the present case it presented as exophytic papillomatous growth which was histo-pathologically characterized as pseudo-epitheliomatous hyperplasia and surface keratinization which was thought to be associated with HPV virus infection. Since, the lesion is non-resolutive, the main treatment modalities include relief from the symptoms like dysphagia, sore throat, and pharyngitis. Similarly, Blood plasmacytosis is an unusual haematological finding that is usually associated with plasma cell leukaemia or advanced stage multiple myeloma, where the plasma cells are a part of the malignant process. Non-malignant reactive peripheral plasmacytosis is rarely found in a of diseases, such as tumours, autoimmune disorders, and infectious diseases that seems most pronounced during the first week of disease and eventually resolves within a few weeks. During the course of infection, the virus and cytokines are detectable in blood, as seen in other virus infections. [ 6 ] IL-6 plays a major role in the proliferation, differentiation, survival and immunoglobulin secretion including the role of other cytokines like IL-6, IL-10, MCP-1, G-CSF and IP-10. [ 7 ] In the present case, viral culture was positive and the lesion clinically presented as a papillary lesion as seen in various HPV- related infections. Differentials of HPV associated reactive plasmacytosis in the present case includes primarily verrucous hyperplasia or carcinoma, proliferative verrucous leukoplakia and multiple myeloma. Verrucous carcinoma and PVL could be ruled out based on the habit history, and the site was also unusual for tobacco associated lesions. Moreover, histologically, no dysplastic changes were observed. Multiple myeloma is a plasma cell disorder leading to dysregulation of bone marrow resulting in cytopenia, bone resorption and multiclonal antibodies production [ 8 ] which were absent in our case. PCM can be treated with either topical, intralesional or systemic corticosteroids based on the severity of the lesion. [ 4 ] In our case excisional biopsy was performed followed by a regular follow-up. Conclusion Plasmacytosis can be manifested orally as an asymptomatic reactive lesion associated with any viral disease or immunologic conditions which is transient and can generally completely disappear within a few weeks. Declarations Author Contribution – Dr. Aishwarya Bhatnagar (Corresponding Author) - Conceptualization, Investigation, Writing - Original Draft Preparation. Dr. Anamika Joshi (Co-Author) - Investigation. Dr. Kailash Chandra Morya (Co-Author) - Visualization. Dr. Kailash Kewalia (Co-Author) - Review & Editing Ethics and Consent to Participate – Ethical Approval – Not Applicable Informed Consent – Verbal Informed Consent was obtained as patient’s identity has not been revealed in article. Funding – No funding was obtained for the study. Conflicts of Interest – No conflicts of interest. References Pellat-Deceunynck C, Jego G, Robillard N, Accard F, Amiot M, Bataille R. Reactive plasmacytoses, a model for studying the biology of human plasma cell progenitors and precursors. Hematol J. 2000;1:362–6. Zhang J, Yan X, Li Y, Gao R, Wang P, Mo W. Reactive plasmacytosis mimicking multiple myeloma associated with SFTS virus infection: a report of two cases and literature review. BMC Infect Dis. 2018;18(1):528. Betz SJ. HPV-Related Papillary Lesions of the Oral Mucosa: A Review. Head Neck Pathol. 2019;13(1):80–90. Antonelli A, Averta F, Diodati F, Muraca D, Brancaccio Y, Mignogna C, Giudice A. An Uncommon Case of Plasma Cell Mucositis of the Tongue in a Young Man. Case Rep Dent. 2020;2020:3429632. Gupta M, Malik S, Kalra R, Sharma N, Singh S, Gupta V, Jain P, Sen R. Etiological Profile of Plasmacytosis on Bone Marrow Aspirates. Dicle Medical Journal 2016; 43(1): 1–4. Thai KT, Wismeijer JA, Zumpolle C, de Jong MD, Kersten MJ, de Vries PJ. High incidence of peripheral blood plasmacytosis in patients with dengue virus infection. Caro, J., Braunstein, M., Williams, L. et al. Inflammation and infection in plasma cell disorders: how pathogens shape the fate of patients. Leukemia 36, 613–624 (2022). Jego G, Robillard N, Puthier D, Amiot M, Accard F, Pineau D, et al. Reactive plasmacytoses are expansions of plasmablasts retaining the capacity to differentiate into plasma cells. Blood. 1999;94:701–12. Additional Declarations No competing interests reported. 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Reactive plasmacytosis is a transient event based on the reflection of immune reactions and it is seldom found in variety of diseases such as infectious diseases, tumour and autoimmune disorders.\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e It has been substantiated that various viral infections including Hepatitis A, Epstein-barr, Dengue virus and Parvovirus B 19 are associated with reactive plasmacytosis.\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e Orally these lesions can be manifested as plasma Cell Mucositis (PCM).\u003c/p\u003e \u003cp\u003eA group of HPV are causative of papillary lesions, clinically presenting an intensely erythematous mucosa with papillomatous, cobblestone, nodular, or velvety surface changes.\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e Symptoms might include dysphagia, oral pain, sore throat, and pharyngitis.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOnly close communication between specialists in several disciplines can differentiate the PCM from other neoplastic conditions. Therefore, it is necessary to perform more specific investigations in order to achieve an appropriate diagnosis and obtain better clinical management.\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e Thus, here we describe a rare case report of a patient that presented with a papillary overgrowth as a manifestation of HPV induced reactive plasmacytosis.\u003c/p\u003e"},{"header":"Case Description","content":"\u003cp\u003eA 32-year-old male patient visited the Department of Oral Medicine and Radiology with a chief complaint of mild pain in the right upper and lower back tooth region from last 5 days. On being asked the patient also reported having mild fever and fatigue 5\u0026ndash;7 days back which subsided on its own, but he was not aware of any other finding in the mouth. No history of weight loss, cutaneous lesions, irritation or rashes was reported. Patient gave no history of any deleterious habit or stress. No significant extraoral finding was obtained.\u003c/p\u003e \u003cp\u003eOn Intraoral examination, a well-defined exophytic overgrowth with whitish papillary projections was observed at the palatal aspect of marginal gingiva with relation to 16, measuring around 1x1.5 cm in dimension. On palpation it was elevated, rough in texture, non-tender and non-scrapable [Figure 1,2]. Based on the clinical appearance and history of the patient a provisional diagnosis of Squamous papilloma or Warts (verruca vulgaris) was given.\u003c/p\u003e \u003cp\u003eOn further investigation, viral culture revealed presence of viral particles within the nuclei. Excisional biopsy was performed and the specimen obtained was 1.6 x 0.6 x 0.4 cm in dimensions. Histopathologic report [Figure \u0026ndash; 3] showed stratified squamous epithelium with pseudo-epitheliomatous hyperplasia and surface keratinization. Sub-epithelium showed dense infiltrate comprising of numerous plasma cells and few lymphocytes. No fungal profile or dysplasia was noted. Radiographic investigations also didn\u0026rsquo;t reveal any significant finding [Figure \u0026ndash; 4]. Based on the investigations, final diagnosis of Warts (HPV) leading to reactive plasmacytosis irt 16 was made. The patient was kept on regular follow-up for 6 months and no recurrence was noted in this time period [Figure \u0026minus;\u0026thinsp;5].\u003c/p\u003e "},{"header":"Discussion","content":"\u003cp\u003ePlasmacytosis, that can also be manifested as PCM, is an idiopathic disorder histologically characterized by dense infiltrates of lymphocytes and plasma cells in submucosa as noted in the present case. In the past, this pathology has been reported under various names according to the anatomical structure involved with the component of plasma cells, such as idiopathic plasmacytosis of the gingiva, plasma cell vulvitis, oral papillary plasmacytosis, or mucous membrane plasmacytosis of the upper aerodigestive tract.\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e The lesions of PCM are usually observed on the mucosal surfaces, gingiva, lips, tongue, buccal mucosa, vulva and penis, epiglottis, and larynx.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e In our case it was present on palatal mucosa.\u003c/p\u003e \u003cp\u003eThe multifactorial mechanism causing proliferation of plasma cells could be considered as a defence response mechanism to the underlying disease processes due to increased release of paracrine growth factors such as cytokines, IL-6 or IL-10.\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e It has been substantiated that various viral infections including Hepatitis A, Epstein-barr, Dengue and Parvovirus B 19 are associated with reactive plasmacytosis. However, PCM is a rare disease, and its exact etiology is not yet known, it is generally reported in patients\u0026rsquo; with previous history of immunologically mediated disease like Sj\u0026ouml;gren syndrome or possible autoimmune hepatitis. It is not noticed in all these cases and also no single disease is consistently associated.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e No evidence of malignant transformation of such lesions has been reported in literatures previously and thus its considered to be a benign condition of adults. Clinically it presents as an intensely erythematous mucosa with papillomatous, nodular, cobblestone or velvety changes on the mucosal surface\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. In the present case it presented as exophytic papillomatous growth which was histo-pathologically characterized as pseudo-epitheliomatous hyperplasia and surface keratinization which was thought to be associated with HPV virus infection. Since, the lesion is non-resolutive, the main treatment modalities include relief from the symptoms like dysphagia, sore throat, and pharyngitis.\u003c/p\u003e \u003cp\u003eSimilarly, Blood plasmacytosis is an unusual haematological finding that is usually associated with plasma cell leukaemia or advanced stage multiple myeloma, where the plasma cells are a part of the malignant process. Non-malignant reactive peripheral plasmacytosis is rarely found in a of diseases, such as tumours, autoimmune disorders, and infectious diseases that seems most pronounced during the first week of disease and eventually resolves within a few weeks. During the course of infection, the virus and cytokines are detectable in blood, as seen in other virus infections.\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e IL-6 plays a major role in the proliferation, differentiation, survival and immunoglobulin secretion including the role of other cytokines like IL-6, IL-10, MCP-1, G-CSF and IP-10.\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e In the present case, viral culture was positive and the lesion clinically presented as a papillary lesion as seen in various HPV- related infections.\u003c/p\u003e \u003cp\u003eDifferentials of HPV associated reactive plasmacytosis in the present case includes primarily verrucous hyperplasia or carcinoma, proliferative verrucous leukoplakia and multiple myeloma. Verrucous carcinoma and PVL could be ruled out based on the habit history, and the site was also unusual for tobacco associated lesions. Moreover, histologically, no dysplastic changes were observed. Multiple myeloma is a plasma cell disorder leading to dysregulation of bone marrow resulting in cytopenia, bone resorption and multiclonal antibodies production \u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e which were absent in our case.\u003c/p\u003e \u003cp\u003ePCM can be treated with either topical, intralesional or systemic corticosteroids based on the severity of the lesion.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e In our case excisional biopsy was performed followed by a regular follow-up.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003ePlasmacytosis can be manifested orally as an asymptomatic reactive lesion associated with any viral disease or immunologic conditions which is transient and can generally completely disappear within a few weeks.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contribution \u0026ndash;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDr. Aishwarya Bhatnagar (Corresponding Author) -\u0026nbsp;Conceptualization, Investigation, Writing - Original Draft Preparation.\u003c/p\u003e\n\u003cp\u003eDr. Anamika Joshi (Co-Author) - Investigation.\u003c/p\u003e\n\u003cp\u003eDr. Kailash Chandra Morya (Co-Author) - Visualization.\u003c/p\u003e\n\u003cp\u003eDr. Kailash Kewalia (Co-Author) -\u0026nbsp;Review \u0026amp; Editing\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics and Consent to Participate \u0026ndash;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical Approval \u0026ndash; Not Applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInformed Consent \u0026ndash; Verbal Informed Consent was obtained as patient\u0026rsquo;s identity has not been revealed in article.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding \u0026ndash;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was obtained for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest \u0026ndash;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo conflicts of interest.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePellat-Deceunynck C, Jego G, Robillard N, Accard F, Amiot M, Bataille R. Reactive plasmacytoses, a model for studying the biology of human plasma cell progenitors and precursors. Hematol J. 2000;1:362\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang J, Yan X, Li Y, Gao R, Wang P, Mo W. Reactive plasmacytosis mimicking multiple myeloma associated with SFTS virus infection: a report of two cases and literature review. BMC Infect Dis. 2018;18(1):528.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBetz SJ. HPV-Related Papillary Lesions of the Oral Mucosa: A Review. Head Neck Pathol. 2019;13(1):80\u0026ndash;90.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAntonelli A, Averta F, Diodati F, Muraca D, Brancaccio Y, Mignogna C, Giudice A. An Uncommon Case of Plasma Cell Mucositis of the Tongue in a Young Man. Case Rep Dent. 2020;2020:3429632.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGupta M, Malik S, Kalra R, Sharma N, Singh S, Gupta V, Jain P, Sen R. Etiological Profile of Plasmacytosis on Bone Marrow Aspirates. Dicle Medical Journal 2016; 43(1): 1\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThai KT, Wismeijer JA, Zumpolle C, de Jong MD, Kersten MJ, de Vries PJ. High incidence of peripheral blood plasmacytosis in patients with dengue virus infection.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCaro, J., Braunstein, M., Williams, L. \u003cem\u003eet al.\u003c/em\u003e Inflammation and infection in plasma cell disorders: how pathogens shape the fate of patients. Leukemia 36, 613\u0026ndash;624 (2022).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJego G, Robillard N, Puthier D, Amiot M, Accard F, Pineau D, et al. Reactive plasmacytoses are expansions of plasmablasts retaining the capacity to differentiate into plasma cells. Blood. 1999;94:701\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Human Papilloma virus, Viral induced, Oral Warts, Reactive Plasmacytosis, Squamous papilloma","lastPublishedDoi":"10.21203/rs.3.rs-3931136/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3931136/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePlasmacytosis is a condition of increased number of plasma cells in tissues, exudate or blood as a defence mechanism. Transient immune reactions in any infection or autoimmune disorder may present as reactive plasmacytosis that might rarely also manifest as plasma cell mucositis. Reactive plasmacytosis has been reported in several viral infections and has been found to completely disappear within 2 weeks. Complete clinical evaluation, individualised investigation and more specific tests are required to rule out these oral manifestations. Thus, we hereby present an extremely rare condition wherein Human Papilloma Virus (HPV) led to reactive plasmacytosis.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e","manuscriptTitle":"Viral Induced Reactive Plasmacytosis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-14 15:22:40","doi":"10.21203/rs.3.rs-3931136/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e0cd8d0e-fc8d-4109-80de-fcbb3b306b4c","owner":[],"postedDate":"February 14th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-02-14T18:20:58+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-14 15:22:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3931136","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3931136","identity":"rs-3931136","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}