scholarly journals RISK OF CIRCULATORY DISEASES ON THE EXAMPLE OF HEART RHYTHM DISORDERS IN PATIENTS WITH SEROLOGICAL MARKERS OF EPSTEIN – BARR INFECTION

2021 ◽  
pp. 150-159
Author(s):  
T.V. Solomay ◽  
◽  
T.A. Semenenko ◽  
N.N. Filatov ◽  
R.I. Khabazov ◽  
...  

To reduce a burden of circulatory diseases (CD) is among primary tasks the state has to solve. There are available data on a contribution made by chronic inflammation on occurrence of heart and vascular diseases. Given that, it seems especially interesting to examine impacts exerted by Epstein-Barr virus infection on CD development. The paper focuses on analyzing morbidity with infectious mononucleosis and CD in the Russian Federation over 1995–2018. 103 patients with heart rhythm disorders and 92 blood donors were examined to determine whether they had immunoglobulins to EBV antigens.The results were statistically processed involving calculation of Pearson’s linear correlation coefficient, error of cor- relation coefficient, validity coefficient, determination coefficient, and frequencies of EBV markers detection per 100 exam- ined people and their confidence intervals. Differences were considered to be authentic when confidence probability was equal to 95 % and confidence significance was p<0.05. Relative risks of heart rhythm disorders in patients with active EBV- infection were calculated as per results obtained via creating a fourfold table. EBV was established to make a significant contribution into circulatory pathology occurrence and it was confirmed by an overall ascending trend in morbidity with infectious mononucleosis and CD in the Russian Federation in 1995-2018 and an authentic strong direct correlation between these two processes (r=0.94; m=0.02; t=47; p<0.01) with determination be- ing equal to 0.88. Risk of developing heart rhythm disorders was determined by active EBV-infection in case history com- bined with detected M-immunoglobulins to capsid EBV antigen and G-immunoglobulins to early EBV antigen, as well as an increase in concentration of G-immunoglobulins to capsid antigen in blood serum (RR=5.8 and 2.3 accordingly). These detected peculiarities require further more profound study and development of activities aimed at risk minimization.

2021 ◽  
pp. 150-159
Author(s):  
T.V. Solomay ◽  
◽  
T.A. Semenenko ◽  
N.N. Filatov ◽  
R.I. Khabazov ◽  
...  

To reduce a burden of circulatory diseases (CD) is among primary tasks the state has to solve. There are available data on a contribution made by chronic inflammation on occurrence of heart and vascular diseases. Given that, it seems especially interesting to examine impacts exerted by Epstein-Barr virus infection on CD development. The paper focuses on analyzing morbidity with infectious mononucleosis and CD in the Russian Federation over 1995–2018. 103 patients with heart rhythm disorders and 92 blood donors were examined to determine whether they had immunoglobulins to EBV antigens The results were statistically processed involving calculation of Pearson’s linear correlation coefficient, error of cor- relation coefficient, validity coefficient, determination coefficient, and frequencies of EBV markers detection per 100 exam- ined people and their confidence intervals. Differences were considered to be authentic when confidence probability was equal to 95 % and confidence significance was p<0.05. Relative risks of heart rhythm disorders in patients with active EBV- infection were calculated as per results obtained via creating a fourfold table. EBV was established to make a significant contribution into circulatory pathology occurrence and it was confirmed by an overall ascending trend in morbidity with infectious mononucleosis and CD in the Russian Federation in 1995-2018 and an authentic strong direct correlation between these two processes (r=0.94; m=0.02; t=47; p<0.01) with determination be- ing equal to 0.88. Risk of developing heart rhythm disorders was determined by active EBV-infection in case history com- bined with detected M-immunoglobulins to capsid EBV antigen and G-immunoglobulins to early EBV antigen, as well as an increase in concentration of G-immunoglobulins to capsid antigen in blood serum (RR=5.8 and 2.3 accordingly).


2019 ◽  
Vol 90 (e7) ◽  
pp. A14.1-A14
Author(s):  
Stephanie L Barnes ◽  
Bruce J Brew

IntroductionInfectious aetiologies such as acute Epstein-Barr virus (EBV) infection are in the differential diagnosis for acute cerebellar ataxia (ACA). This syndrome remains exceptionally rare and not well characterised in adults.e.g. 1 2MethodsA retrospective case review of a patient diagnosed with ACA following EBV infection with implications for pathogenesis and treatment.ResultsA 29-year-old Caucasian male presented with a three day history of ACA. Seven days prior he was diagnosed with infectious mononucleosis; bloodwork was consistent with acute EBV infection. These symptoms improved rapidly with oral prednisolone. He took no regular medications, drank alcohol moderately and had no significant family history.On examination, he was afebrile, ataxic and mildly dysarthric. Sensory examination was normal, particularly proprioception. Romberg’s test was negative. Remaining neurological and general examination was normal.Bloodwork showed mild liver dysfunction and positive ANA (titre 1/320, homogenous and speckled patterns). Immune screen was otherwise negative. Antineuronal antibody panel was negative in serum and CSF. CSF glucose was 3.1 mmol/L, protein 751 mg/L, albumin 523 mg/L, neopterin 24 nmol/L and B2 microglobulin 1.1 mg/L. The sample was acellular with negative EBV PCR (<500 copies/mL). Other infective serology and PCRs were also negative. MRI brain with gadolinium showed no abnormality.The patient received supportive care and was neurologically normal within three months.ConclusionsACA related to EBV is rare in adults. This report is important because it documents an adult case, other ACA causes have been rigorously excluded, resolution without antiviral therapy is detailed, and investigations support an immune-mediated pathogenesis.ReferencesMcCarthy CL, McColgan P, Martin P. Acute cerebellar ataxia due to Epstein-Barr virus. Pract Neurol 2012;12:238–240.Lascelles RG, Longson M, Johnson PJ, Chiang A. Infectious mononucleosis presenting as acute cerebellar syndrome. Lancet 1973;2:707.


2020 ◽  
Author(s):  
Ashvin Kuri ◽  
Benjamin Meir Jacobs ◽  
Nicola Vickaryous ◽  
Julia Pakpoor ◽  
Jaap Middeldorp ◽  
...  

AbstractBackgroundEpstein-Barr Virus (EBV) is a ubiquitous gamma-herpesvirus with which ∼95% of the healthy population is infected. EBV infection has been implicated in a range of haematological malignancies and autoimmune diseases. Delayed primary EBV infection increases the risk of subsequent complications. Over recent decades, the age of primary EBV infection has become later, largely due to improved sanitation and living conditions.Methods and findingsFirst, we conducted a sero-epidemiological survey of healthy volunteers between 0 and 25 years old to assess prevalence of detectable anti-EBV antibodies. 1982 of 2325 individuals (85.3%) were EBV seropositive. EBV seropositivity increased monotonically with age, and increased more among females than males during adolescence (ages 10 – 15). Second, we conducted a retrospective review of Hospital Episode Statistics to determine changes in Infectious Mononucleosis (IM) incidence over time. Between 2002 and 2013, the incidence of IM (derived from hospital admissions data) increased. We then conducted a large case-control study of 6306 prevalent IM cases and 1,009,971 unmatched controls extracted from an East London GP database to determine exposures associated with IM. Exposures associated with lower risk of IM were elevated BMI (Overweight OR 0.80 [0.75 to 0.86], obese OR 0.63 [0.57 to 0.70]), non-white ethnicity (Black OR 0.21 [0.18 to 0.23], Asian OR 0.14 [0.13 to 0.16], Other ethnicity OR 0.22 [0.19 to 0.25]), and a history of smoking (OR 0.87 [0.83 to 0.92]), whereas affluence was associated with a higher risk of IM (per increase in IMD decile OR 1.15 [1.13 to 1.17]. Finally, we used ELISA to determine antibody responses to common pathogens and vaccine antigens among EBV-seronegative individuals. EBV-seronegative donors did not display diminished serum antibody responses to pertussis, rubella, or varicella compared to EBV-seropositive donors.ConclusionsIn this study we make several important observations on the epidemiology of EBV infection in the UK. We find that overall EBV seroprevalence in the UK appears to have increased, and that the sharp increase in EBV seropositivity takes places earlier among females than males. We find that the incidence of IM requiring hospitalisation is increasing. We find that exposures associated with prevalent IM in a diverse population include white ethnicity, affluence, lower BMI, and never-smoking, and these exposures interact with each other. Lastly, we provide pilot evidence suggesting that antibody responses to vaccine and encountered pathogens do not seem to be diminished among EBV-seronegative individuals, which is a theoretical counter-argument to developing EBV vaccines. Our findings could help to inform vaccine study designs in efforts to prevent IM and late complications of EBV infection, such as Multiple Sclerosis.Key messages-Epstein-Barr Virus (EBV) is a ubiquitous virus which infects over 95% of the world’s population. The majority of infection is silent and without consequence. In a subset of individuals, EBV is thought to play a role in the pathogenesis of autoimmune disease and haematological cancers.-During childhood and adolescence, EBV seroprevalence increased monotonically with age from 0-5 (67.8% females, 72.0% males) to 20-25 (96.4% females, 95.5% males)-The incidence of Infectious Mononucleosis (IM) leading to hospital admission has increased over the past decade-Exposure associated with IM in a large, diverse East London cohort (n>1,000,000) were low BMI, never-smoking, white ethnicity, and affluence.


2006 ◽  
Vol 59 (3-4) ◽  
pp. 179-182 ◽  
Author(s):  
Predrag Canovic ◽  
Olgica Gajovic ◽  
Zoran Todorovic ◽  
Zeljko Mijailovic

Introduction. Primary Epstein-Barr virus infection (EBVI) in children is usually asymptomatic with seroconversion. If primary infection occurs in adolescents or in adulthood, the most common manifestation is acute infectious mononucleosis. The diagnosis of acute infectious mononucleosis is made by virus and serologic tests. The most important evidence of primary EBV infection includes IgM class antibodies detected by using EBV virus-capsidantigen (EBV VCA) which appears at the beginning of illness and usually lasts 1 to 2 months. Paul Bunnell Davidson test, although non-specific, is still in use today in diagnosis of infectious mononucleosis and for detection of heterophile antibodies. Case report. Acute hepatitis with icterus is a rare clinical manifestation in primary EBV infection. However, sometimes it is the only manifestation of the disease. This is a case report of a patient with EBV hepatitis and icterus associated with long-lasting fever without pharyngitis and lymphadenopathy, which are characteristics of infectious mononucleosis. The etiologic diagnosis was confirmed by positive Paul Bunnell Davidson test and by detection of specific antibodies (class IgM) to EBV VCA in patient's serum. Discussion. The pathogenetic mechanism which causes destruction of hepatic cells and provokes cholestasis during EBV infection, has not been cleared yet. It is supposed that EBV has no direct cytocide effects on hepatic cells, yet destruction of these cells is caused by toxic action of free radicals through lipid peroxidation. Patients with infectious mononucleosis have autoantibodies directed against enzyme superoxide-dismutase which neutralizes enzyme's antioxidant action. As a result of this action, free radicals accumulate in hepatic cells and cause their damage. Conclusion. Icteric forms of EBV infection are rare. In differential diagnosis of icterus caused by infectious agents, one should not forget EBV. .


2021 ◽  
Vol 13 (1) ◽  
pp. 86-90
Author(s):  
Carlos Leganés Villanueva ◽  
Ilaria Goruppi ◽  
Nuria Brun Lozano ◽  
Federica Bianchi ◽  
María Quinteiro González ◽  
...  

Epstein–Barr virus (EBV) is estimated to infect more than 98% of adults worldwide and is one of the most common human viruses. Acute acalculous cholecystitis (AAC) of the gallbladder is an atypical complication of infectious mononucleosis caused by EBV. Conservative management has been described in the context of AAC caused by EBV. A surgical approach must be considered in the case of acute complications such as perforation or gallbladder gangrene. We present the case of a 10-year-old female patient with AAC due to infectious mononucleosis syndrome caused by primary EBV infection.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Zuhal Yesilbag ◽  
Asli Karadeniz ◽  
Fatih Oner Kaya

Primary Epstein-Barr virus (EBV) infection is almost always a self-limited disease characterized by sore throat, fever, and lymphadenopathy. Hepatic involvement is usually characterized by mild elevations of aminotransferases and resolves spontaneously. Although isolated gallbladder wall thickness has been reported in these patients, acute acalculous cholecystitis is an atypical presentation of primary EBV infection. We presented a young women admitted with a 10-day history of fever, nausea, malaise who had jaundice and right upper quadrant tenderness on the physical examination. Based on diagnostic laboratory tests and abdominal ultrasonographic findings, cholestasis and acute acalculous cholecystitis were diagnosed. Serology performed for EBV revealed the acute EBV infection. Symptoms and clinical course gradually improved with the conservative therapy, and at the 1-month follow-up laboratory findings were normal. We reviewed 16 adult cases with EBV-associated AAC in the literature. Classic symptoms of EBV infection were not predominant and all cases experienced gastrointestinal symptoms. Only one patient underwent surgery and all other patients recovered with conservative therapy. The development of AAC should be kept in mind in patients with cholestatic hepatitis due to EBV infection to avoid unnecessary surgical therapy and overuse of antibiotics.


Blood ◽  
1976 ◽  
Vol 47 (1) ◽  
pp. 91-98
Author(s):  
CA Horwitz ◽  
W Henle ◽  
G Henle ◽  
H Polesky ◽  
H Wexler ◽  
...  

Over several years sera were collected from 14 heterophil-positive students or patients who did not fulfill minimal hematologic criteria for infectious mononucleosis (I.M.) The specificity of these heterophil reactions for I.M. was investigated by determining antibodies to Epstein-Barr virus-determined antigens, i.e., to viral capsid antigens (VCA), early antigens (EA), and EBV-associated nuclear antigens (EBNA). On the basis of detectable anti-EA and/or the early absence and late emergence of anti-EBNA, four of these 14 individuals showed evidence of a current or very recent primary Epstein-Barr virus infection. The other ten patients showed antibody patterns indicative of Epstein-Barr virus infections in the past, and no firm conclusions could be drawn with regard to the specificity of their heterophil reactions. It was assumed, however, that some represented atypical clinical forms of EBV infection and that timing of specimen collection was a factor in explaining the paucity of Downey cells. In three patients, the absorbed heterophil-positive reactions persisted with little change in titer for at least 22 mo and thus might represent false-positive tests.


Author(s):  
O. Abrahamovych ◽  
U. Abrahamovych ◽  
S. Guta ◽  
M. Farmaha ◽  
L. Kobak

Introduction. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by various manifestations and clinical course, many aspects of the etiology and pathogenesis of which remain unclear. Recently, the interest of researchers in studying the role of cytomegalovirus (CMV) and Epstein - Barr virus (EBV) has been growing in the occurrence and course of a number of human diseases due to their ability to affect almost all organs and systems of the body, causing the formation of latent, active or chronic infection, which can often cause temporary disability, disability or even death, however, for the patients with SLE, despite the possibility of approaching the difficult problem of diagnosis and treatment of this disease, this issue is given insufficient attention, as evidenced by isolated studies.The aim of the study. Detect cytomegalovirus and Epstein - Barr infection in patients with systemic lupus erythematosus and its dependence on gender and age of patients. Materials and methods of research. The study involved 120 patients (15 men (12.50%) and 105 women (87.50%) aged 18 to 69 years with SLE, who were in the rheumatology department of the Communal Non-Commercial Enterprise of the Lviv Regional Council "Lviv Regional Clinical Hospital" in 2014-2019. To diagnose CMV and EBV infection by enzyme-linked immunosorbent assay, antibodies of IgM and IgG to viruses were detected in blood serum, and viruses were detected by polymerase chain reaction. According to the results of virus detection, formed groups of the patients, namely: patients with active CMV infection, active EBV, active CMV and EBV, without active CMV and EBV. All patients with SLE included in the study were subsequently stratified by age according to the classification of the World Health Organization (2015), according to which the following age limits were determined: young age, middle-aged, elderly, senile. Statistical analysis was performed on a personal computer in MS Excel and Statistica 6.0 using descriptive statistics. The frequency of cases of active CMV and EBV infection was calculated mathematically by the binomial coefficient of I. Newton. Research results and their discussion. We found in the vast majority of patients with SLE (117 patients, 97.50%) increase in the titer of specific antibodies to CMV. Only in 3 patients (2.50%) the titer of antibodies to this virus was within normal limits. Analyzing the frequency of EBV infection in patients with SLE, we recorded an increase in the titer of specific antibodies to the virus in 119 patients (99.17%). Among the examined patients with SLE in all (100.00%) found an increase in the titer of antibodies to CMV and / or EBV, of which 97.50% - infected with CMV and 97.17% - infected with EBV. The active phase of CMV and / or EBV infection was detected in 54.17%, of which 23.33% - active CMV infection, 17.50% - active EBV infection and 12.50% - a combination of active CMV and EBV infection simultaneously, which indicates a high frequency of CMV and EBV infection in patients with SLE and reflects the urgency of the problem of diagnosing herpesvirus infection in them. We found that activeCMV, EBV infections and their combinations are present only in women (64 patients, which is 60.96% of the total number of women with SLE), of which 28 patients (26.67%) there was only active CMV infection, in 21 patients (20.00%) - only active EBV infection and in 15 patients (14.29%) – combination of active CMV and EBV infection. 41 women (39.05%) and all (100.00%) men were not found to have active CMV and EBV infection, which indicates that men at the time of the survey were significantly more likely to have this infection in the integration phase. The most frequently active EBV infection was detected in patients with SLE of young age (17 cases, 24.64%), and in middle-aged patients 3 cases (6.52%) were recorded, which indicates a significant (p <0.05) difference in the frequency of cases of active EBV infection in patients of both groups. Only 1 case (20.00%) of active EBV infection was detected in elderly patients. Conclusions. All patients with systemic lupus erythematosus are infected - 97.50% with cytomegalovirus and 97.17% with Epstein-Barr virus infection, that was confirmed by the increased titer of antibodies to them. Among the mentioned patients 53.33% of them had the active phase of infection (23.33% - cytomegalovirus infection in the replication phase, 17.50% - the Epstein- Barr virus infection in the replication phase and 12.50% - their combination). The prevalence of active viral infection in patients with systemic lupus erythematosus depends on gender (active cytomegalovirus, active Epstein-Barr virus infection and their combination are significantly more common in women) and age - they are probably more common in young patients.  


2021 ◽  
pp. 549-554
Author(s):  
Berrin Pelit Uzunalimoğlu ◽  
Abdülhamit Sağlam ◽  
Büşra Şişman ◽  
Sefer Günaydın ◽  
Esen Gül Uzuner ◽  
...  

Epstein-Barr virus (EBV) has been associated with a plethora of neurological manifestations including polyneuropathy and polyradiculopathy. A 27-year-old man with a recent upper respiratory system infection presented with difficulty in walking. His neurological examination revealed reduced muscle strength in both proximal and distal lower limb muscles without sensory and autonomic signs. Needle electromyography showed abnormal spontaneous activity and reduced recruitment of motor units in muscles innervated by multiple lumbo-sacral roots. Cerebrospinal examination showed increased protein levels with normal cell counts. While spinal MRI was normal, whole-body CT and PET examination showed disseminated lymph node enlargement. Anti-EBV viral capsid antigen and anti-nuclear antigen IgG but not IgM was positive, whereas EBV PCR was negative in blood. Analysis of inguinal lymph node biopsy showed reactive lymphoid hyperplasia and EBV DNA. Leucine-rich glioma-inactivated protein 1 (LGI1) antibody was found in serum but not in CSF. All clinical, imaging, and electrophysiological findings improved following steroid and intravenous immunoglobulin treatment. These findings suggested the acute involvement of lumbo-sacral spinal roots and/or motor neurons. Purely motor polyradiculopathy has been reported in both EBV-positive and LGI1 antibody-positive patients, and EBV infection is known to precede different autoimmune manifestations. Whether EBV infection may trigger LGI1 autoimmunity and cause involvement of spinal motor roots and/or motor neurons needs to be further studied.


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