Epstein-Barr virus reactivation induced myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA)-associated vasculitis

We present a patient with systemic symptoms including 4 months of dyspnoea worsened with exertion, fatigue, rhinorrhoea, intermittent facial swelling, generalised lymphadenopathy and weight loss. Laboratory studies demonstrated proteinuria and eosinophilia. His serology was consistent with Epstein-Barr Virus (EBV) reactivation. A lymph node biopsy was consistent with EBV-associated reactive lymphoid hyperplasia. He was told to continue symptomatic treatment for EBV infection. After several admissions, vasculitis workup and myeloperoxidase-antineutrophil cytoplasmic autoantibody (ANCA) studies were positive. Evolution of clinical symptoms, laboratory parameters and our literature review suggested the diagnosis of EBV-associated ANCA vasculitis. Steroids were started after the patient continued to deteriorate; the viral load started increasing, so we added valganciclovir with favourable clinical response and no relapse during the follow-up for 6 months. This suggests that with evidence of viraemia (primary or reactivation), antiviral treatment likely has clinical benefit while immunosuppression is being considered.

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Detection of specific lytic and latent transcripts can help to predict the status of Epstein-Barr virus infection in transplant recipients with high virus load.

Acta Biochimica Polonica ◽

10.18388/abp.2008_3029 ◽

2008 ◽

Vol 55 (4) ◽

pp. 693-699 ◽

Cited By ~ 10

Author(s):

Barbara Zawilinska ◽

Anna Kosinska ◽

Marzena Lenart ◽

Jolanta Kopec ◽

Beata Piatkowska-Jakubas ◽

...

Keyword(s):

Epstein Barr Virus ◽

Clinical Symptoms ◽

Peripheral Blood Leukocyte ◽

Productive Infection ◽

Epstein Barr Virus Infection ◽

Virus Reactivation ◽

Transplant Recipients ◽

Type Iii ◽

Barr Virus ◽

Epstein Barr

Epstein-Barr virus (EBV), a member of the family Herpesviridae, is widely spread in the human population and has the ability to establish lifelong latent infection. In immunocompetent individuals the virus reactivation is usually harmless and unnoticeable. In immunocompromised patients productive infection or type III latency may lead to EBV-associated post-transplant lymphoproliferative disorder (PTLD). The aim of our research was to investigate the utility of PCR-based methods in the diagnosis and monitoring of EBV infections in bone marrow transplant recipients. Thirty-eight peripheral blood leukocyte samples obtained from 16 patients were analysed, in which EBV DNA was confirmed by PCR. We used semi-quantitative PCR to estimate the viral load and reverse-transcription PCR (RT-PCR) to differentiate between latent and productive EBV infection. In 14 patients we confirmed productive viral infection. We observed a correlation between higher number of EBV genome copies and the presence of transcripts specific for type III latency as well as clinical symptoms.

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Rare case of Visceral form of Infectious Mononucleosis in Irkutsk Region

Acta biomedica scientifica ◽

10.29413/abs.2018-3.6.24 ◽

2019 ◽

Vol 3 (6) ◽

pp. 164-167

Author(s):

N. K. Bobrova ◽

E. Yu. Zorkaltseva

Keyword(s):

Infectious Mononucleosis ◽

Epstein Barr Virus ◽

Clinical Symptoms ◽

Hypochromic Anemia ◽

Symptomatic Treatment ◽

Neural System ◽

Unknown Etiology ◽

Barr Virus ◽

Leading Role ◽

Epstein Barr

Infectious mononucleosis (MI) is caused by the Herpes viridae family of viruses. Currently, most researchers assign a leading role to the Epstein-Barr virus. In present time there are no unified clinical classification of infection mononucleosis, but many authors recognize the visceral form which involves cardiovascular system, adrenal glands, lungs, central neural system and others organs. The article describes a clinical case of MI in the 28-year-old patient. She applied for medical help with complaints of fever up to 39 °C, weakness in the legs and arms, weight loss and received symptomatic treatment on an outpatient department. After 2 months on the background of deterioration, she was hospitalized in an infectious diseases hospital with severe symptoms of intoxication, lymphoproliferative syndrome, myocarditis, pericarditis, hepatitis, polyneuropathy with quadriparesis, hypochromic anemia, thrombocytopenia. She was consulted by an oncologist and diagnosed with cervical cancer. Laboratory confirmation was obtained – Epstein-Barr virus was detected in the blood. Against the background of antiviral therapy, a regression of clinical symptoms was achieved in a week. The patient was transferred to a oncological hospital. It is recommended to examine patients with high fever of unknown etiology on myocardial infarction for the timely appointed etiotropic therapy.

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