RESUMO
Epstein-Barr virus (EBV) is globally prevalent and in adolescents mostly observed as infectious mononucleosis. Abnormal liver blood tests are common, whereas more serious hepatitis is less prevalent. Autoimmune haemolytic anaemia may also occur in the course of this infection. We report a case of a 15-year-old girl with cholestatic hepatitis and autoimmune haemolytic anaemia associated with EBV infection. The Donath-Landsteiner test was positive suggesting paroxysmal cold haemoglobinuria. She was treated with supportive care and discharged in recovery after three weeks.
Assuntos
Anemia Hemolítica Autoimune/virologia , Infecções por Vírus Epstein-Barr/complicações , Hepatite Viral Humana/virologia , Adolescente , Anemia Hemolítica Autoimune/diagnóstico , Anemia Hemolítica Autoimune/terapia , Infecções por Vírus Epstein-Barr/diagnóstico , Infecções por Vírus Epstein-Barr/terapia , Feminino , Hemoglobinúria Paroxística/diagnóstico , Hemoglobinúria Paroxística/terapia , Hemoglobinúria Paroxística/virologia , Hepatite Viral Humana/diagnóstico , Hepatite Viral Humana/terapia , Herpesvirus Humano 4/isolamento & purificação , HumanosAssuntos
Anemia Aplástica/diagnóstico , Anemia Aplástica/terapia , Hemoglobinúria Paroxística/diagnóstico , Hemoglobinúria Paroxística/terapia , Animais , Doenças da Medula Óssea , Transtornos da Insuficiência da Medula Óssea , Infecções por Vírus Epstein-Barr/complicações , Guias como Assunto , Transplante de Células-Tronco Hematopoéticas , Hemoglobinúria Paroxística/virologia , Herpesvirus Humano 4/isolamento & purificação , Humanos , Terapia de ImunossupressãoAssuntos
Eritema Infeccioso/complicações , Hemoglobinúria Paroxística/virologia , Falência Hepática Aguda/virologia , Parvovirus B19 Humano/isolamento & purificação , Adulto , Anemia Aplástica , Doenças da Medula Óssea , Transtornos da Insuficiência da Medula Óssea , Diagnóstico Diferencial , Eritema Infeccioso/diagnóstico , Feminino , Hemoglobinúria Paroxística/diagnóstico , Humanos , Falência Hepática Aguda/diagnósticoRESUMO
Paroxysmal cold haemoglobinuria (PCH) is an autoimmune disorder characterized by intravascular haemolysis causing haemoglobinuria. It is due to a biphasic haemolysin known as the Donath-Landsteiner antibody, which binds specifically to the P antigen of red blood cells at low temperatures, leading to complement activation and red cell lysis at 37 degrees C. PCH is a rare disease which predominantly affects the paediatric population, occurring mostly during viral infections. We report on what is possibly the first case of PCH in an adult to be precipitated by chicken pox infection.
Assuntos
Varicela/complicações , Temperatura Baixa/efeitos adversos , Hemoglobinúria Paroxística/virologia , Anticorpos Antivirais/sangue , Feminino , Herpes Zoster/imunologia , Humanos , Imunoglobulina G/análise , Imunoglobulina M/análise , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To establish B cell lines from patients with paroxysmal nocturnal haemoglobinuria (PNH) and normal controls. METHODS: B lymphoid cells prepared from PNH patients and normal controls were infected with EB virus. Phenotype of the immortal cells was analyzed by flow cytometry. The immunomagnetic beads were used to select CD(55)(-) and CD(59)(-) B lymphoid cells, which were cloned by limiting dilution. The clonality of the cloned cells was confirmed by testing the pattern of Ig rearrangements using polymerase chain reaction (PCR). RESULTS: From 2 PNH patients and 2 normal controls, CD(55)(-) and CD(59)(-) B lymphoblastoid cell lines were established which had PNH phenotype and normal phenotype, respectively. CONCLUSION: B lymphoid cell lines from PNH patients can be obtained by EB virus infection.
