Complication Of Epstein-Barr Virus Infection Research Articles

Are Selected Cytokines and Epstein-Barr Virus DNA Load Predictors of Hepatological Complications of Epstein-Barr Virus Infection in Children?

The aim of the study was to evaluate tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), soluble intracellular adhesion molecules 1 (s-ICAM-1) and Epstein-Barr virus (EBV) DNA load levels as predictors of hepatological complications of EBV infection in children. The study group consisted of 54 children aged one to eighteen years, who were hospitalised from 1 December 2018 to 31 December 2020 in the Department of Paediatrics, Infectious Diseases and Hepatology and who had hepatological complications in the course of serologically and molecularly confirmed EBV infection. It was shown that IL-6, TNF-α, and s-ICAM-1 concentrations were the highest in patients with hepatitis and biliary pole damage. Higher EBV DNA viremia positively correlated with increased C-reactive protein (CRP) and TNF-α levels and increased leukocyte, lymphocyte, and monocyte counts. Increases in lymphocyte counts and TNF-α concentrations were observed along with increases in gamma-glutamyl transpeptidase (GGTP) activity. Increased concentrations of IL-6, TNF-α, and s-ICAM-1 may indicate the risk of hepatitis with concomitant biliary pole damage during EBV infection.

Significance of expression of selected miRNAs in the diagnosis of hepatological complications of Epstein-Barr virus infection in children.

To assess the expression of selected miRNAs as predictive factors of hepatological complications in Epstein-Barr virus (EBV)-infected children. This study included 68 children infected with EBV aged 1 to 18 years hospitalised between 01.12.2018 and 31.12.2020 in the Department of Paediatrics, Infectious Diseases and Hepatology. The expression of 5 miRNAs (miR-122-5p, miR-21-3p, miR-34a-5p, miR-26b-5p, miR-199a-5p) was analysed by real-time PCR using the TaqMan Fast Advanced Master Mix kit. In the group of EBV-infected children, statistically significantly higher expression for miR-21-3p, miR-122-5p, miR-26b-5p and miR-34a-5p was confirmed. In a group of 54 children diagnosed with hepatitis, along with an increase in alanine aminotransferase (ALT) and g-glutamyl transpeptidase (GGTP) activity, an increase in expression of miR-21-3p, miR-122-5p, miR-26b-5p, miR-34a-5p and miR-199a-5p was observed. Increased expression of miR-21-3p, miR-122-5p, miR-26b-5p, miR-34a-5p and miR-199a-5p in EBV-infected children appears to be a risk factor for hepatological complications progressing to biliary pole defects.

Acute Acalculous Cholecystitis from Infection with Epstein-Barr Virus in a Previously Healthy Child: A Case Report.

BackgroundAcute cholecystitis is the acute inflammation of the gallbladder. In adults it is most frequently caused by a gallstone(s) obstructing outflow from the cystic duct, leading to gallbladder distention and edema with eventual development of biliary stasis and bacterial overgrowth, often requiring operative management. However, in children acalculous cholecystitis is more common and is often the result of an infectious process.Case ReportHere we present a case of acute acalculous cholecystitis caused by infection with Epstein-Barr virus in an otherwise healthy three-year-old male.ConclusionAcalculous cholecystitis is an uncommon but potentially significant complication of Epstein-Barr virus infection in the pediatric population. Emergency providers should consider this diagnosis in any child being evaluated for EBV with the complaint of abdominal pain.

Postmortem diagnosis of fulminant infectious mononucleosis

Fulminant infectious mononucleosis (FIM) is a rare but life-threatening complication of Epstein-Barr virus infection that usually affects immunodeficient individuals. It is a hyperinflammatory syndrome caused due to release of massive amount of various cytokines, leading to hemophagocytic lymphohistiocytosis on histopathology, and a plethora of clinical manifestations due to simultaneous involvement of multiple organs of the body. The case of a young male who presented with fever and dyspnea and died within 12 h of presentation to the hospital was taken for autopsy. The postmortem evidence of hemophagocytic lymphohistiocytosis in the spleen, bone marrow, lymph nodes, liver, and lungs and the presence of large, basophilic intranuclear inclusions that stained latent membrane protein-1 positive on immunohistochemistry led to the diagnosis of FIM.

Rare Presentation of Epstein Barr Virus

Two rare complication of infection with the Epstein-Barr virus is the development of hemophagocytic Lymphohistiocytosis and opsoclonus myoclonus syndrome. Here we are describing two cases which are describing these complications of Epstein-Barr virus infection. As they mimic several other condition but a strong suspicion is needed to diagnose these rare complications early as it will help us to reduce morbidity and mortality of these complications.J Nepal Paediatr Soc 2015;35(3):290-292

EBV‐associated hemophagocytic syndrome

General aspect of the marrow: macrophages with prominent phagocytosis of red cells, platelets, and erythroblasts. The marrow is overall hypocellular (MGG, original magnification ×400). High-power view of two characteristic hemophagocytic macrophages. (A) A macrophage with ingested red cells, platelets, erythroblasts, neutrophil, and assorted debris. (B) A macrophage which has engulfed a large number of erythroblasts (MGG, original magnification ×1,000). Hemophagocytic syndrome or hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome characterized by fever, pancytopenia, organomegaly, multiorgan dysfunction, and hemophagocytosis by a large number of macrophages in bone marrow and other tissues [1]. Central to the pathophysiology is the impaired activity of NK and cytotoxic T lymphocytes resulting in uncontrolled immune activation, hypercytokinemia, and proliferation of macrophages. The diagnosis of HLH relies upon well-established criteria [2]. The syndrome has been described in familial conditions or as a secondary phenomenon to infections, malignancies, and collagen vascular diseases. HLH in the context of infection is best described in association with Epstein-Barr virus (EBV). EBV-associated HLH can occur either in primary infection or as a consequence of viral reactivation. EBV can also be the trigger in both familial and secondary cases. Although uncommon, hemophagocytic syndrome is a serious complication of EBV infection and can be fatal in many cases. Early recognition and prompt initiation of treatment are of great importance to reduce the high morbidity and mortality associated with this condition. The history and representative images from a case of EBV-associated hemophagocytic syndrome are described. The patient's consent has been obtained. A 25-year-old woman was admitted with fever, pancytopenia, and hepatic dysfunction. Five weeks previously, she was diagnosed with infectious mononucleosis on the basis of pharyngitis, fever, and positive EBV antibodies. In the weeks after diagnosis, she continued to complain of intermittent fevers and sweating. Past medical and family history were unremarkable. Physical examination revealed temperature 38°C, icteric sclera, and hepatosplenomegaly. Laboratory values included hemoglobin 8.1 g/dL, leucocytes 2,100 μL−1, neutrophils 720 μL−1, platelets 40,000 μL−1, bilirubin 7.4 mg/dL, ALT 135 U/L, LDH 1,080 U/L, triglycerides 459 mg/dL, and ferritin 6,070 ng/mL. Peripheral blood film morphology was unremarkable. The direct and indirect antiglobulin test and screening for cold autoagglutinins gave negative results. The reticulocyte automated count and absolute value were 1.11% and 31,900 μL−1, respectively, indicating impaired production of red cells. Bone marrow aspiration showed numerous macrophages with striking phagocytosis of blood cells and marrow precursors (Images 1 and 2). EBV serologies indicated primary infection, and the EBV-PCR result was 18,000 copies/mL. Genetic testing for familial HLH was negative. The patient was treated with methylprednisolone and intravenous immunoglobulins and eventually recovered completely.

Parálisis facial bilateral secundaria a infección por virus de Epstein-Barr

Two young patients with bilateral facial palsy are described. They initially presented unilateral facial palsy, followed by contralateral facial nerve involvement a few days later, together with clinical and serologic evidence of acute Epstein-Barr virus infection. The outcome was favourable in one patient but severe sequels persisted in the second. These two cases show that this infrequent complication of Epstein-Barr virus infection may not always have a good outcome. The pathogenic mechanism of bilateral facial palsy is discussed.

Hemorrhage into a Preformed Splenic Cyst as a Rare Complication of Epstein-Barr Virus Infection

Hemorrhage into a Preformed Splenic Cyst as a Rare Complication of Epstein-Barr Virus Infection

Strategies for Epstein–Barr Virus Monitoring, Detection and Therapy in Post-transplant Lymphoproliferative Disorder

Epstein–Barr virus (EBV) is a significant cause of morbidity and mortality in solid-organ transplant (SOT) recipients. The most serious complication of EBV infection in this population is post-transplant lymphoproliferative disorder (PTLD). EBV-viral load monitoring can be used to predict those SOT patients at high risk of PTLD, particularly those who are EBV seronegative prior to transplant. Surveillance EBV-load monitoring to inform pre-emptive reduction of immunosuppression has contributed to the decrease in the incidence of PTLD in SOT recipients. The use of the anti-CD20 antibody, rituximab, as a therapeutic agent is increasing, with anecdotal reports of positive outcomes. However, experience to date suggests that the use of this agent may not prevent recurrence of the tumor or improve cell-mediated immune responses to EBV. Future investigation of EBV-specific T-cell responses as an adjunct to monitoring, and the adoptive transfer of EBV-specific cytotoxic T lymphocytes appear likely in future attempts as a means to limit the consequences of EBV infection in the SOT population.

Advanced therapeutic and prophylactic strategies for Epstein–Barr virus infection in immunocompromised patients

Epstein–Barr virus (EBV) is an ubiquitous human herpesvirus. Primary infection is generally subclinical but in certain circumstances, such as in patients with either hereditary or secondary immunodeficiency, EBV infection may cause overt disease that is often lethal. Strategies for the prophylaxis and treatment of these potentially life-threatening complications of EBV infection have advanced dramatically. They include immunological-based approaches targeted at EBV-infected cells, as well as improvement in the treatment of the underlying and predisposing disease. This review will discuss EBV biology and immune events that occur in both immunocompetent and immunocompromised individuals and introduce the novel prophylactic and therapeutic strategies for EBV-associated life-threatening diseases.

Epstein-Barr virus and the nervous system.

The neurological complications of Epstein-Barr virus infection include viral meningitis, encephalitis and neuromuscular complications. The introduction of cerebrospinal fluid polymerase chain reaction for Epstein-Barr virus DNA has improved diagnosis of these conditions and of primary central nervous system lymphoma in acquired immune deficiency syndrome, and has enabled cerebrospinal fluid monitoring of therapy. Prognosis remains good for most Epstein-Barr virus-related neurological complications; for primary central nervous system lymphoma in acquired immune deficiency syndrome the prognosis is still poor.

Brain-Stem Encephalitis Caused by Epstein-Barr Virus

A case of brain-stem encephalitis with strong serologic evidence of acute Epstein-Barr virus infection is described. Recovery was rapid without treatment, but mild neurologic sequelae were seen at 6-month follow-up. Epstein-Barr virus infection in childhood may be asymptomatic and heterophil antibody negative. Encephalitis is an unusual but well-recognized complication of Epstein-Barr virus infection, but localized brain-stem involvement, to our knowledge, has not been previously described.