Mucocutaneous Manifestations of Epstein-Barr Virus Infection (original) (raw)
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Epstein-Barr virus associated diseases: an update
The Malaysian journal of pathology, 1993
The Epstein-Barr virus (EBV), traditionally linked etiologically with infectious mononucleosis (IM), endemic Burkitt lymphoma (BL) and nasopharyngeal carcinoma (NPC) has in recent years been associated with a host of other conditions. Viral strategies for entry into cells and persistence, as well as various molecular mechanisms involved in latency, replication and transformation have been elucidated. EBV termini analysis has demonstrated the essentially clonal nature of BL, NPC and preneoplastic lesions of the nasopharynx. Strain variation between isolates of EBV suggests that differences in epithelial cell tropism among strains may exist. Treatment of EBV-associated syndromes is largely supportive although antivirals may play a role in the management of oral hairy leukoplakia. At the present time, the development of an effective vaccine remains a viable proposition.
Chronic Epstein-Barr virus infection causing both benign and malignant lymphoproliferative disorders
Korean Journal of Pediatrics, 2014
The Epstein-Barr virus (EBV) is oncogenic and can transform B cells from a benign to a malignant phenotype. EBV infection is also associated with lymphoid interstitial pneumonia (LIP). Here, we report the case of a 14-year-old boy who was diagnosed with a latent EBV infection and underlying LIP, without any associated immunodeficiency. He had been EBV-seropositive for 8 years. The first clinical presentations were chronic respiratory symptoms and recurrent pneumonia. The symptoms worsened in the following 2 years. The results of in situ hybridization were positive for EBV, which led to a diagnosis of LIP. The diagnosis was confirmed by the results of a thoracoscopic lung biopsy. The EBV titer of the bronchoalveolar lavage specimens obtained after acyclovir treatment was found to be fluctuating. The patient had latent EBV infection for 8 years, until presented at the hospital with intermittent abdominal pain and distension. Physical examination and pelvic computed tomography revealed a large mesenteric mass. A biopsy of the excised mass led to a diagnosis of Burkitt's lymphoma (BL). The patient received combination chemotherapy for 4 months, consisting of vincristine, methotrexate, cyclophosphamide, doxorubicin, and prednisolone. He is now tumor-free, with the LIP under control, and is being followed-up at the outpatient clinic. This is the first report of a Korean case of chronic latent EBV infection that developed into LIP and BL in a nonimmunocompromised child.
Epstein-Barr virus-associated lymphoproliferative disorders
Postępy Higieny i Medycyny Doświadczalnej, 2013
The Epstein-Barr virus (EBV) is one of the most common human viruses, infecting more than 90% of the world's adult population. In some individuals the interplay between EBV replication, latency and immune control can be disrupted and evokes prolonged proliferation of EBV-infected lymphocytes and their malignant transformation. Since its discovery as the first human tumor virus, EBV has been implicated in the development of a wide range of human cancers. The evidence for an association with EBV is the strongest for Burkitt's lymphoma, NK/T cell lymphoma, nasopharyngeal carcinoma, Hodgkin's lymphoma and for malignant lymphomas in immune incompetent patients. Additionally, certain epithelial cell tumors, such as gastric carcinoma and breast carcinoma, have been defined as EBV related. However, the virus may be encountered in other types of malignancies. The oncogenic potential of EBV is related to its ability to infect and transform B lymphocytes into continuously growing lymphoblastoid cell lines. EBV encodes a series of products mimicking several growth, transcription and anti-apoptotic factors, to usurp control of the pathways that regulate diverse homeostatic cellular functions. However, the exact mechanism by which EBV promotes oncogenesis remains unclear. The focus of this review is to summarize the current knowledge of oncogenic potential of the Epstein-Barr virus and its role in the pathogenesis of EBV-associated lymphoproliferative disorders.
Epstein-Barr virus-related lymphoproliferative disorders
Current Hematologic Malignancy Reports, 2007
Epstein-Barr virus (EBV) is a ubiquitous gammaherpesvirus that persists in carriers as a lifelong, mostly asymptomatic infection. EBV is associated with a variety of lymphomas and lymphoproliferative disorders. In this review we provide an update of the relevant literature on EBV-associated lymphoproliferative disorders, with particular emphasis on epidemiology, pathogenesis, and novel treatment approaches.
Journal of Medical Virology, 1990
Epstein-Barr virus (EBV) is often associated with lethal lymphoproliferative diseases in immunologically compromised individuals. Recently, we have studied a 20-month-old boy with X-linked lymphoproliferative disease (XLP) who had succumbed to infectious mononucleosis (IM) complicated by fulminant hepatitis and virus-associated hemophagocytic syndrome following EBV infection. EBV genomes were detected in peripheral blood lymphocytes (PBL), cervical and mesenteric lymph nodes, liver, spleen, thymus, and bone marrow. According to restriction endonuclease analyses, the EBV-DNA pattern was similar in all samples except for the EBV-DNA from the bone marrow. Additionally, circular EBV-DNA (suggesting a latent infection) predominated in spontaneously established lymphoblastoid cell lines (LCLs) derived from both the lymph node and cord lymphocytes co-cultured with PBL. In contrast, both circular and linear EBV-DNA (suggesting a lytic infection) were noted in spontaneously established LCLs derived from his PBL. Furthermore, LCLs derived from both the lymph node and cord lymphocytes cocultured with PBL expressed fewer reactive cells for early antigen (EA) and viral capsid antigen (VCA) than spontaneous LCLs from his PBL, thus providing evidence for different B cellular susceptibility to EBV infection in this patient with XLP. Finally, defective EBV-specific cytotoxic T cell activity was observed in this patient. Latent EBV infected cells may easily escape immunosurveillance by the host. These findings may explain the fatal course of EBV infection in this patient.
Epstein-Barr virus and skin manifestations in childhood
International journal of dermatology, 2013
Epstein-Barr virus (EBV) is a human B-lymphotropic herpes virus and one of the most common viruses in humans. Specific skin signs related to EBV infection are the exanthem of mononucleosis, which is observed more frequently after ingestion of amoxicillin, and oral hairy leukoplakia, a disease occurring mostly in immunocompromised subjects with HIV infection. Other more uncommon cutaneous disorders that have been associated with EBV infection include virus-related exanthems or diseases such as Gianotti-Crosti syndrome, erythema multiforme, and acute genital ulcers. Other skin manifestations, not correlated to virus infection, such as hydroa vacciniforme and drug-induced hypersensitivity syndrome have also been linked to EBV. The putative involvement of EBV in skin diseases is growing similarly to other areas of medicine, where the role of EBV infection is being investigated in potentially debilitating inflammatory diseases. The prognosis of EBV infection in healthy, immunocompetent i...
American Journal of Hematology, 1987
This report describes a patient who developed a malignant proliferation of granular lymphocytes following Epstein-Ban virus (EBV) infection. For many months, his illness resembled prolonged infectious mononucleosis with persistent fatigue, fever, leukocytosis, and serologic evidence of recent primary EBV infection. After approximately 1 year, however, he developed progressive granular lymphocytosis and extensive lymphocytic infdtration of the bone marrow and liver. Tests for EBV DNA in pre-and postmortem tissue samples using a sensitive DNA hybridization technique were negative. Southern blot analysis of DNA prepared from blood mononuclear cells demonstrated clonal T-cell antigen receptor gene rearrangement. Despite increased numbers of circulating lymphocytes with the morphology and surface phenotype of normal donor natural killer (NK) cells, the patient's NK activity was consistently depressed in a standard in vitro assay. However, in vitro incubation with interleukin-2 (IL-2), but not with a-or y-interferon, increased the NK activity of the patient's lymphocytes. Intravenous recombinant IL-2 treatment transiently increased the patient's blood NK activity and was associated with seroconversion to EBV nuclear antigens but failed to affect the progression of his disease. Our findings indicate that clonal granular lymphocytic proliferation may develop after EBV infection and confirm the utility of DNA hybridization analysis in distinguishing monoclonal from benign immunoreactive lymphoproliferation. Furthermore, our results suggest that certain functionally inert neoplastic granular lymphocytes acquire NK activity when exposed to IL-2.
Differential Clinical Presentations of Epstein-Barr Virus Infection and a Brief Literature Review
Gastroenterology Nursing, 2012
E pstein-Barr virus is the causative agent of infectious mononucleosis syndrome, characterized by viral fever, sore throat, and lymphadenopathy. In this article, several cases of infectious mononucleosis syndrome presenting with differential clinical characteristics are described with a brief literature review. Epstein-Barr virus (EBV), a member of the gamma herpes virus family, is a common virus worldwide that is the causative agent of infectious mononucleosis syndrome. Although EBV infections are generally asymptomatic during childhood, symptomatic presentation is more common with increasing age. Approximately 80%-90% of patients with EBV infection remain undiagnosed as the asymptomatic increase in liver function tests is the only manifestation in the majority of the cases (Crum, 2006; Schooley, 2000). Cholestatic hepatitis, liver failure (due to acute or chronic disease), autoimmune hepatitis, hepatocellular carcinoma, and splenic rupture have all been reported in association with EBV infection. In this article, several different clinical pictures of EBV infection are reported, along with a brief literature review.
EBV-positive mucocutaneous ulcers: a presentation of two cases and a brief literature review
Surgical and Experimental Pathology, 2019
Mucocutaneous ulcers associated with the Epstein Barr virus constitute an EBV-induced B-cell lymphoproliferative disorder first described in 2010 by Stefan D. Dojcinov et al. These lesions can occur in association with a spectrum of immunosuppressive conditions, including primary immune deficiency, Human Immunodeficiency Virus (HIV) infection, post-transplantation and the use of methotrexate or tumor necrosis factor-alpha (TNF-a) antagonists. Patients clinically present with slowly developing indurated cutaneous and/or mucosal ulcers, especially in the oropharynx. Histopathology reveals circumscribed ulcers containing a mixture of lymphocytes, plasma cells, histiocytes, eosinophils and large transformed cells resembling Hodgkin and Reed-Sternberg cells. The adjacent squamous epithelium presents reactive nuclear atypia and pseudoepitheliomatous hyperplasia. The large transformed cells show positivity for CD20, CD30, Oct-2, PAX5 and EBV. These cells are also positive for MUM1, yet lac...