Specific Viral Etiology Research Articles

The spectrum of liver disease in systemic lupus erythematosus: Report of 33 histologically-proved cases and review of the literature

The charts of 238 patients with systemic lupus erythematosus (SLE) were reviewed. Although not routinely screened for biochemical evidence of liver disease, 124 of 206 patients tested had at least one abnormal result, and 43 met strict criteria for the existence of liver disease. In most patients, a specific viral or drug etiology could not be implicated. The spectrum of liver disease in 33 patients from whom liver tissue was available included cirrhosis, chronic active hepatitis, granulomatous hepatitis, chronic persistent hepatitis and steatosis. Three of four cirrhotic patients demonstrated a peculiar form of cholestasis which resembled a “canalicular cast” of bile. Of the nine patients who had serial liver biopsies, four showed progression of their disease. Three patients died of liver failure. Liver involvement in SLE is more common than previously recognized. Severe and even fatal liver disease can occur.

Simultaneous infection with multiple herpesviruses

Active dual infection with Epstein-Barr virus (EBV) and cytomegalovirus (CMV) was observed in four otherwise healthy persons with mononucleosis syndromes. A secondary serologic response to EBV occurred in three patients as determined by the presence of antibodies to EBV-induced nuclear antigen (EBNA) early in the illness. All four patients lacked heterophil antibodies; in the one case tested, immunoglobulin M (IgM) antibodies specific for EBV viral capsid antigen (VCA) were absent as well. The Guillain-Barré syndrome occurred in one patient, who also had active infection with herpes simplex virus 1 (HSV-1). In a fifth patient, herpes zoster developed complicating heterophil-positive infectious mononucleosis due to primary infection with EBV.These five cases demonstrate that mononucleosis syndromes may occur in association with dual or multiple herpesvirus infections and that reactivation of EBV may be common during heterophil-negative mononucleosis. Reactivation of latent virus is most likely related to depressed cellular immunity due to a primary infection with another herpesvirus. An alternate hypothesis is that viral DNA polymerase induced by infection with one herpesvirus might simultaneously permit the productive replication of a second herpesvirus previously latent within the same cell. Thus, reactivation may result from molecular interactions between viruses at the cellular level.The possibility of multiple infections must be considered whenever determining the specific viral etiology of heterophil-negative mononucleosis.

Resistance to viral infection. Interferon.

Progress in the treatment of infectious disease has advanced with remarkable speed and efficiency in the last 20 years. With the advent of antibiotic therapy, many of the bacterial infections which were hitherto not easily managed have been controlled with a resultant decrease in mortality and morbidity. As the number and the severity of bacterial diseases decrease, viral infections have become increasingly more important clinically, particularly because an effective antiviral agent has not been developed, but also because the specific viral etiology of an increasing number of clinical conditions has been elucidated. In the past, most efforts aimed at containing virus disease have been through the institution of preventive measures such as immunization with killed virus particles or the use of attenuated live virus which produced mild or subclinical infections. Passive immunity with pooled sera or one of their fractions has also provided some degree of protection or modification of

Acute respiratory illnesses among children and adults. Field study of contemporary importance of several viruses and appraisal of the literature.

Extensive epidemiologic-laboratory investigations were conducted in which the specific viral etiology was defined in 40% of acute respiratory illnesses in children and in 20% of such illnesses among adults. Included in the latter group was the "common cold" caused by coryzaviruses. Evidences were presented for simultaneous infection with more than one virus in certain cases of respiratory disease. Review of the contemporary literature made possible an appraisal of the relative importance of the individual viruses in acute respiratory illnesses and provided a rationale for future development of vaccines which may afford protection against a significant portion of the respiratory disease spectrum.

Treatment of complicated colds with acellular bacterial antigen complex.

The common cold^1,2is our greatest single cause of illness. Although the common cold has a specific viral etiology, its most frequent complications are bacterial. These bacterial complications—sinusitis, pharyngitis, laryngitis, tracheitis, bronchitis, bronchiectasis, and infectious asthma—follow the growth of the common Gram-positive pathogens,²particularly Staphylococcus aureus. Recurrent upper respiratory infections are the largest single cause³of all diseases treated in general practice and pediatrics. These infections do not remain localized in the ear, nose, throat, and bronchi, but become systemic with serious complications. Serious bronchopulmonary complications in children,⁴such as bronchiectasis and infectious asthma, can frequently be accounted for by some previous acute respiratory infection or a series of such infections, frequently repeated. These children⁴in their medical history show evidence of an inherited tendency to allergy, an acquired sensitivity to bacteria, and an unstable autonomic nervous system. In adults who are highly susceptible to

Mumps Complicated by Myocarditis, Meningoencephalitis and Pancreatitis

MUMPS is usually considered to be an acute systemic disease of specific viral etiology with a special predilection for the parotid glands. The common complications are orchitis, pancreatitis, oophoritis, mastitis and meningitis or meningoencephalitis, or both. Myocarditis has until the past few years been considered a rare and unusual complication. Several studies recently made call attention to the occurrence of myocarditis during the convalescent course of epidemic parotitis. It is the purpose of this paper to submit a case report as additional evidence to support the belief that mumps is a generalized infectious process and that the myocardium and pericardium . . .