Abstract
We here report the case of a young Japanese woman diagnosed with chronic active Epstein-Barr virus (EBV) infection. Intensive therapy with the CHOP regimen was partially able to control virus expansion, but various central nervous system symptoms appeared and gradually progressed. EBV-encoded RNA, detected using in situ hybridization, disclosed the presence of EBV in liver and bone marrow tissue, and real-time PCR revealed the presence of EBV in the cerebrospinal fluid (CSF) and serum. CD3+CD4+CD8-CD56- T-cell expansion in the peripheral blood (PB) and CSF was also observed. Atrophic brain changes were progressive, and the patient died of central nervous system disturbance and pulmonary hemorrhage a year after diagnosis. Autopsy revealed that EBV-infected T lymphocytes with a phenotype similar to those seen in PB and CSF had infiltrated multiple organs: the lymph nodes, bone marrow, endocardium, pericardium, myocardium, spleen, liver, and spinal cord. There have been few previous reports of severe degenerative changes in the myocardium, liver, and spinal cord in patients with EBV infection. Although EBV occasionally infiltrates the central nervous system and brain, atrophic changes mediated by EBV are rare. The autopsy results ...Continue Reading
References
Jan 1, 1992·Neuroradiology·H ShojiM Watanabe
Jan 1, 1991·Clinical Microbiology Reviews·M OkanoD T Purtilo
Dec 1, 1987·Scandinavian Journal of Immunology·E FrancoH Yabuuchi
Mar 1, 1988·The Journal of Infectious Diseases·S E Straus
Jun 2, 1988·Nature·H KikutaT Kinoshita
Jan 17, 1987·Lancet·K Kawa-HaH Yabuuchi
Jun 1, 1996·American Journal of Clinical Pathology·A NakagawaK Hayashi
Nov 24, 1999·Journal of Neurovirology·A KrivineP Lebon
May 29, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·H KaneganeG Tosato
Aug 17, 2000·The New England Journal of Medicine·J I Cohen
Oct 24, 2000·Bone Marrow Transplantation·N FujiiM Harada
Dec 7, 2000·The Journal of Infectious Diseases·S OhgaT Hara
Jan 17, 2002·International Journal of Hematology·M YagitaK Kawa
Feb 25, 2003·The Journal of Infectious Diseases·Hiroshi KimuraUNKNOWN Japanese Association for Research on Epstein-Barr Virus and Related Diseases
Feb 26, 2003·Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology·Jun OgawaNobuyuki Miyasaka
Mar 5, 2003·The Lancet Infectious Diseases·Karen F Macsween, Dorothy H Crawford
Apr 30, 2003·Nihon rinsho. Japanese journal of clinical medicine·Tatsuya Tsurumi
Sep 25, 2003·Neurology·R A Du PasquierI J Koralnik
Jul 23, 2005·Journal of Neurovirology·Hirofumi SawaWilliam W Hall
Aug 16, 2005·Reviews in Medical Virology·Yoshihiro TsutsuiHideya Kawasaki
Sep 3, 2005·American Journal of Hematology·Motohiko OkanoShinsaku Imashuku
Sep 27, 2005·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Shinya HaraHiroshi Kimura
Oct 26, 2005·American Journal of Hematology·Masataka IshimuraToshiro Hara
Mar 15, 2006·International Journal of Hematology·M KoyamaK Kawa
Aug 12, 2006·Blood·Jehan DupuisUNKNOWN Groupe d'Etude des Lymphomes de l'Adulte (GELA)
May 19, 2007·American Journal of Clinical Pathology·Robert P Hasserjian, Nancy Lee Harris
Jun 15, 2007·International Journal of Hematology·Masao NakagawaUNKNOWN Clinical Oncology Forum
Oct 12, 2007·The Journal of Neuroscience : the Official Journal of the Society for Neuroscience·Mehrdad AlirezaeiHoward S Fox
Jan 1, 1986·Immunology Today·A B Rickinson
Citations
Jul 1, 2009·Pathology International·Yuko NomuraKoichi Ohshima
Oct 25, 2014·Rinshō shinkeigaku = Clinical neurology·Shohei WatanabeHiroo Yoshikawa
Feb 18, 2016·Leukemia & Lymphoma·Norimichi HattoriTsuyoshi Nakamaki
Sep 17, 2008·Journal of the Neurological Sciences·Zen KobayashiHidehiro Mizusawa