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1.
Wiad Lek ; 73(8): 1796-1799, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055354

RESUMO

We've reported a clinical case of congenital hemolytic anemia which was treated in Vinnitsa Regional Children's Hospital from newborn period until now. We've used complete blood count, biochemichal blood investigation, ultrasound investigation of the abdominal cavity in every hospitalization. Also IFA for TOXO IgG, IgM and G CMV, IgG HSV-6 IgG EBV (EBNA) and IgM EBV, study to hepatitis B and C viruses and HIV were made. There were checked levels of serum iron, ferritin, vitamin B 12 and folic acid in blood serum.


Assuntos
Anemia Hemolítica Congênita , Infecções por Vírus Epstein-Barr , Anemia Hemolítica Congênita/complicações , Anticorpos Antivirais , Criança , Infecções por Vírus Epstein-Barr/complicações , Herpesvirus Humano 4/imunologia , Humanos , Imunoglobulina M , Recém-Nascido
2.
Acta Gastroenterol Belg ; 83(3): 485-487, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33094599

RESUMO

BACKGROUND: Epstein-Barr virus infection is common, with seroprevalence of 90% in adults. Clinical presentation of primary EBV infection can be variable and atypical. It is often subclinical or can result in infectious mononucleosis. Clinical course is mostly benign, but in rare cases serious short- and long-term complications may occur. CASE PRESENTATION: We present a case of a 19-year-old woman who was admitted to the hospital with general malaise, fever, dyspnea, icterus, vomiting and diarrhea, with acute left upper quadrant pain. She was diagnosed with acute EBV-infection with hepatitis, splenomegaly and spontaneous splenic rupture. CONCLUSIONS: Spontaneous splenic rupture is an uncommon, but potentially fatal complication of infectious mononucleosis. In a patient with suspicion of EBV infection and abdominal pain, we should always be aware of the possibility of spontaneous splenic rupture and emphasis should be put on appropriate counseling.


Assuntos
Infecções por Vírus Epstein-Barr , Mononucleose Infecciosa , Ruptura Esplênica , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/diagnóstico , Feminino , Herpesvirus Humano 4 , Humanos , Mononucleose Infecciosa/complicações , Mononucleose Infecciosa/diagnóstico , Estudos Soroepidemiológicos , Adulto Jovem
4.
J Investig Med High Impact Case Rep ; 8: 2324709620950107, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32787459

RESUMO

Hemophagocytic lymphohistocytosis (HLH) is a hyperinflammatory syndrome characterized by fever, hepatosplenomegaly, and pancytopenia. It may be associated with genetic mutations or viral/bacterial infections, most commonly Epstein-Barr virus (EBV) and cytomegalovirus. As for the novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), also known as COVID-19 (coronavirus disease-2019), the cytokine storm it triggers can theoretically lead to syndromes similar to HLH. In this article, we report a case of a 28-year-old female who presented with high-grade fevers, found to have both SARS-CoV-2 and EBV infections, and eventually began to show signs of early HLH. To our knowledge, this is the first case reported in literature that raises the possibility of SARS-CoV-2-related HLH development.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Infecções por Vírus Epstein-Barr/diagnóstico , Herpesvirus Humano 4/isolamento & purificação , Linfo-Histiocitose Hemofagocítica/imunologia , Pneumonia Viral/complicações , Adulto , Infecções por Coronavirus/diagnóstico , Infecções por Vírus Epstein-Barr/complicações , Feminino , Humanos , Pandemias , Pneumonia Viral/diagnóstico
5.
Int J Hematol ; 112(4): 568-576, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32666469

RESUMO

To investigate the efficacy and safety of the Janus kinase inhibitor ruxolitinib in the treatment of recurrent or refractory hemophagocytic lymphohistiocytosis (HLH) in children. We performed a retrospective analysis of ruxolitinib in children with recurrent or refractory HLH in Beijing Children's Hospital. All patients were treated firstly with HLH-94 protocol. Patients received oral ruxolitinib on a continuous 28-day cycle or until disease progression or unacceptable toxicity. The median age of enrolled patients was 1.7 years (range 9 months-5.0 years). The median time from the beginning of first-line treatment to the initiation of ruxolitinib was 3 (2-6) weeks. The median follow-up time was 14 months (1 week-24 months). Five children were diagnosed with EBV-related HLH, two with familial HLH, one with autoinflammatory disease-related HLH, and the other with unclear etiology. After the first-line treatment, seven patients had no remission (NR). The other two patients relapsed within 2-4 weeks after complete remission (CR). After oral administration of ruxolitinib, all patients' body temperatures decreased to the normal range within 48 h. At 1 week of receiving ruxolitinib, three patients (33.3%) achieved partial remission (PR). Five patients (55.6%) improved but did not achieve PR. One patient (11.1%) died. Compared with other causes of HLH, children with refractory or recurrent EBV-HLH had a poor response to ruxolitinib alone (Fisher's exact test, P = 0.048). Until the last follow-up, the three patients who achieved CR survived without recurrence. For children with recurrent or refractory HLH, ruxolitinib is a tolerable salvage therapy. Although some children could not achieve CR after one week of treatment, combination with chemotherapy could gain time for further treatment or bone marrow transplantation.


Assuntos
Linfo-Histiocitose Hemofagocítica/terapia , Pirazóis/administração & dosagem , Administração Oral , Fatores Etários , Autoimunidade , Criança , Pré-Escolar , Infecções por Vírus Epstein-Barr/complicações , Feminino , Seguimentos , Humanos , Linfo-Histiocitose Hemofagocítica/etiologia , Linfo-Histiocitose Hemofagocítica/genética , Masculino , Recidiva , Indução de Remissão , Estudos Retrospectivos , Terapia de Salvação , Fatores de Tempo , Resultado do Tratamento
6.
Ann Hematol ; 99(7): 1575-1581, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32500223

RESUMO

This study investigated the clinical characteristics of Hodgkin lymphoma-associated hemophagocytic lymphohistiocytosis (HLH-HL). Clinical data of 8 patients with HLH-HL and 20 non-HLH-HL patients were included. All eight HLH-HL patients tested positive for plasma Epstein-Barr virus (EBV)-DNA and EBV-encoded small RNA (EBER), and six patients were positive for EBV-DNA in the peripheral blood mononuclear cells (PBMCs). Two out of the 20 non-HLH-HL patients were confirmed positive for EBER, and the remaining 18 patients were negative. Among the HLH-HL patients, five patients received ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine) chemotherapy regimens in other hospitals, and their conditions were considered to be worse, for which reason they were transferred to our center, and three patients were treated with DEP (doxorubicin-etoposide-methylprednisolone) regimens to target HLH and were alive as of the writing of this article. Two patients were critically ill upon admission and were not able to undergo chemotherapy. Significant differences in survival time were observed between the HLH-HL and non-HLH-HL patients (P = 0.005). HL patients found positive for EBV (plasma/PBMCs EBV-DNA(+)/EBER(+)) may be more likely to develop HLH-HL. It may be beneficial to target HLH during the acute phase of HLH, followed by treating HL once the HLH condition has stabilized. HLH-HL patients have worse prognosis and higher mortality than non-HLH-HL patients.


Assuntos
Doença de Hodgkin/mortalidade , Doença de Hodgkin/terapia , Linfo-Histiocitose Hemofagocítica/mortalidade , Linfo-Histiocitose Hemofagocítica/terapia , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bleomicina/uso terapêutico , Estudos de Casos e Controles , Dacarbazina/uso terapêutico , Doxorrubicina/uso terapêutico , Infecções por Vírus Epstein-Barr/sangue , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/mortalidade , Infecções por Vírus Epstein-Barr/terapia , Etoposídeo/uso terapêutico , Feminino , Herpesvirus Humano 4/isolamento & purificação , Doença de Hodgkin/sangue , Doença de Hodgkin/complicações , Humanos , Linfo-Histiocitose Hemofagocítica/sangue , Linfo-Histiocitose Hemofagocítica/complicações , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Vimblastina/uso terapêutico , Adulto Jovem
7.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(6): 620-625, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32571462

RESUMO

OBJECTIVE: To study the effect of genetic variation on the prognosis of children with Epstein-Barr virus (EBV)-positive hemophagocytic lymphohistiocytosis (HLH) and its association with cytokines. METHODS: A total of 81 EBV-positive HLH children who received the sequencing of related genes were enrolled. According to the results of gene detection, they were divided into a non-mutation group and a mutation group. According to the pattern of gene mutation, the mutation group was further divided into three subgroups: single heterozygous mutation (SHM), double heterozygous mutation (DHM), and homozygous or compound heterozygous mutation (H-CHM). The serum levels of cytokines were measured and their association with HLH gene mutations was analyzed. RESULTS: UNC13D gene mutation had the highest frequency (13/46, 28%). The STXBP2 c.575G>A(p.R192H) and UNC13D c.604C>A(p.L202M) mutations (likely pathogenic) were reported for the first time. The mutation group had a significantly higher level of tumor necrosis factor alpha (TNF-α) than the non-mutation group, while it had a significantly lower level of interferon gamma (IFN-γ) than the non-mutation group (P<0.05). The IL-4 level of the DHM subgroup was higher than that of the non-mutation group, while the IL-4 level of the H-CHM subgroup was lower than that of the DHM group (P<0.0083). The H-CHM subgroup had a significantly lower 1-year overall survival rate than the non-mutation group, the SHM subgroup, and the DHM subgroup (39%±15% vs 85%±6%/86%±7%/91%±9%, P=0.001). CONCLUSIONS: There is a significant reduction in IFN-γ level in the mutation group. Children with homozygous or compound heterozygous mutation tend to have poorer prognosis, while other mutations do not have a significant impact on prognosis.


Assuntos
Infecções por Vírus Epstein-Barr , Linfo-Histiocitose Hemofagocítica , Criança , Citocinas , Infecções por Vírus Epstein-Barr/complicações , Testes Genéticos , Herpesvirus Humano 4 , Humanos , Linfo-Histiocitose Hemofagocítica/genética , Proteínas de Membrana , Células Th1 , Células Th2
8.
Ann R Coll Surg Engl ; 102(8): 616-620, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32538153

RESUMO

INTRODUCTION: Upper urinary tract urothelial carcinomas are very rare tumours with different biological behaviours. The Epstein-Barr virus, which is the first known oncogenic virus, is being investigated for various malignant tumours. It is known that this virus is associated with nasopharyngeal carcinoma, as well as multiple haematological malignancies, head and neck and gastric cancers. We aimed to determine the presence of the Epstein-Barr virus in upper urinary tract urothelial carcinomas using chromogenic in situ hybridisation (CISH). MATERIALS AND METHODS: A total of 44 upper urinary tract urothelial carcinomas from two different centres were included. Demographic data and survival rates were obtained from hospital records. One demonstrative paraffin block from each case was stained using Epstein-Barr encoded RNA (EBER) with an automated CISH procedure. The positivity of EBER was statistically analysed for prognostic factors. RESULTS: Among all patients, 38 were male and 6 were female. The mean age of the patients was 65.93 years. At the time of the study, 15 patients had died and 29 were alive. EBER-CISH positivity was found in 13 patients. Four showed strong EBER-CISH expression and nine showed weak expression. EBER-CISH positivity was not statistically related to any of the prognostic factors or to overall survival. DISCUSSION: Although EBER-CISH positivity showed no significant relation with prognostic factors, it was observed in one-third of all cases. Therefore, we think that the Epstein-Barr virus may have a role in the pathogenesis of upper urinary tract urothelial carcinomas. This finding needs to be supported by larger studies.


Assuntos
Infecções por Vírus Epstein-Barr , Herpesvirus Humano 4 , Neoplasias Urológicas , Urotélio , Idoso , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/mortalidade , Infecções por Vírus Epstein-Barr/patologia , Infecções por Vírus Epstein-Barr/cirurgia , Feminino , Humanos , Hibridização In Situ , Masculino , Pessoa de Meia-Idade , Neoplasias Urológicas/mortalidade , Neoplasias Urológicas/patologia , Neoplasias Urológicas/cirurgia , Neoplasias Urológicas/virologia , Urotélio/cirurgia , Urotélio/virologia
9.
Int J Hematol ; 112(4): 592-596, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32514927

RESUMO

Increased incidence of lymphoproliferative disorders is reported in patients with autoimmune diseases, majority of which have a B-cell phenotype and are pathogenetically associated with the reactivation of Epstein-Barr virus (EBV). However, EBV-associated T/NK-cell lymphoma has hardly been reported. We present the case of a 68-year-old-woman, who had been diagnosed with systemic lupus erythematosus (SLE) 28 years back and was treated with various immunosuppressive agents including steroids, cyclophosphamide, and tacrolimus. She presented with a progressively worsening swelling of the right thigh for the last few months. Radiological examination revealed an intramuscular bulky tumor without any other lesions and the biopsy results led to a diagnosis of extranodal NK/T-cell lymphoma, nasal type (ENKL). Concurrent chemoradiotherapy resulted in a complete response, which has been sustained for more than 2 years without requiring additional therapy. After the initiation of chemotherapy, SLE did not worsen with the administration of low-dose corticosteroids. To the best of our knowledge, this is the first case report of a localized extranasal ENKL developing in a patient with SLE.


Assuntos
Quimiorradioterapia , Lúpus Eritematoso Sistêmico/complicações , Linfoma Extranodal de Células T-NK/terapia , Neoplasias Musculares/terapia , Idoso , Infecções por Vírus Epstein-Barr/complicações , Feminino , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Linfoma Extranodal de Células T-NK/diagnóstico , Linfoma Extranodal de Células T-NK/etiologia , Neoplasias Musculares/diagnóstico , Neoplasias Musculares/etiologia , Coxa da Perna , Resultado do Tratamento
10.
Am J Med Sci ; 360(4): 402-405, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32591093

RESUMO

Dermatomyositis is an inflammatory disorder involving muscle and skin. Similar to many other autoimmune diseases, environmental factors appear to trigger the onset of disease in some cases. Many drugs have been reported to be associated with dermatomyositis, and rarely infections have been described as potential triggering agents. Here we are describing a case of dermatomyositis that developed after doxycycline and levofloxacin use, who also had recent Epstein-Barr virus infection. Dermatomyositis associated with doxycycline or levofloxacin use has not yet been described in the literature, while reports of dermatomyositis after Epstein-Barr virus infection have been rare and limited to juvenile dermatomyositis or in association with cancer. It is important for clinicians to be aware of this rare association so that the diagnosis and treatment can be exercised promptly.


Assuntos
Antibacterianos/efeitos adversos , Dermatomiosite/induzido quimicamente , Dermatomiosite/virologia , Doxiciclina/efeitos adversos , Infecções por Vírus Epstein-Barr/complicações , Levofloxacino/efeitos adversos , Antígenos Virais/sangue , Proteínas do Capsídeo/sangue , Dermatomiosite/sangue , Dermatomiosite/tratamento farmacológico , Infecções por Vírus Epstein-Barr/sangue , Antígenos Nucleares do Vírus Epstein-Barr/sangue , Humanos , Resultado do Tratamento
11.
Pediatrics ; 145(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32430444

RESUMO

Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) is a common type of hemophagocytic lymphohistiocytosis (HLH) that exhibits high rates of morbidity and fatalities. Multiorgan failure caused by Epstein-Barr virus (EBV)-induced hypercytokinemia is one of the main reasons for early deaths. Blood purification techniques have been successfully applied in previously treated hypercytokinemia. However, there were insufficient studies to support the combination of plasma exchange (PE) and continuous renal replacement therapy (CRRT) in treating patients with severe EBV-HLH. In this article, we have summarized the effects of early incorporation of PE and CRRT, together with HLH-2004 chemoimmunotherapy, in 8 pediatric patients with severe EBV-HLH. Early use of PE and CRRT appeared to be well tolerated, and no serious side effects and early deaths were observed. After PE and CRRT procedures, cytokine levels were reduced to normal values, except for soluble interleukin 2 receptor, and significant reductions in EBV DNA, serum ferritin, aspartate transaminase, total bilirubin, total bile acid, lactate dehydrogenase, and body temperature values and increases in the neutrophil count in addition to hemoglobin, albumin, and cholinesterase values were observed. Furthermore, through continuous HLH-2004 treatment regimens, lower limits of detection were exhibited for EBV DNA levels, and all other observational indicator levels were restored to normal. Finally, 7 patients achieved and maintained complete remission for 15 to 24 months, culminating in August 2019. Therefore, it is our suggestion that early incorporation of PE and CRRT with chemoimmunotherapy might be a safe and effective treatment for patients with severe EBV-HLH.


Assuntos
Infecções por Vírus Epstein-Barr/terapia , Linfo-Histiocitose Hemofagocítica/terapia , Troca Plasmática/métodos , Terapia de Substituição Renal/métodos , Índice de Gravidade de Doença , Criança , Pré-Escolar , Terapia Combinada/métodos , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/diagnóstico , Feminino , Humanos , Lactente , Linfo-Histiocitose Hemofagocítica/complicações , Linfo-Histiocitose Hemofagocítica/diagnóstico , Masculino
12.
Medicine (Baltimore) ; 99(18): e19930, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358363

RESUMO

INTRODUCTION: Epstein-Barr virus (EBV) associated smooth muscle tumors (SMTs) usually present under the condition of immunosuppression, including congenital immunodeficiency syndrome-SMT, post-transplantation-SMT and HIV-SMT. HIV-SMTs are most likely to invade the central nervous system, followed by the liver, lungs, and other locations. Many laboratory techniques, including serological techniques, polymerase chain reaction and immunohistochemistry (IHC), are employed to determine the aetiologies of these tumours. With respect to therapy, surgical resection is the main treatment. In patients with immunodeficiency, improving immune status is significant for defending against other viruses. We describe a case of the primary focus of SMT in the liver of HIV-positive patient without any metastasis. PATIENT CONCERNS: A young male HIV-positive patient complained of fever and abdominal pain for 2 months. DIAGNOSIS: IHC of liver tissue confirmed the finding: EBV-related smooth muscle tumor. INTERVENTIONS: Given the patient's general condition, he was not a suitable candidate for surgical resection. He was given antibiotics, antifungal agents and EBV-directed agents to control infection as well as highly active antiretroviral therapy to enhance the immunity. OUTCOMES: The patient's symptoms improved. He was discharged. CONCLUSIONS: In conclusion, EBV-related HIV-SMTs is a rare neoplasm found in the liver among immunodeficient patients. This case highlights that a variety of examinations such as IHC for smooth muscle markers (smooth muscle actin and desmin) and EBER, as well as polymerase chain reaction for EBV DNA should be done when diagnoses are ambiguous.


Assuntos
Síndrome de Imunodeficiência Adquirida/complicações , Infecções por Vírus Epstein-Barr/complicações , Fígado/patologia , Tumor de Músculo Liso/complicações , Tumor de Músculo Liso/diagnóstico , Adulto , Humanos , Masculino
13.
PLoS One ; 15(5): e0232474, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32374757

RESUMO

BACKGROUND: In Brazil, penile cancer (PC) is not uncommon. The highest incidence of PC is in the North and Northeast of the country. In addition to phimosis, the Human Papillomavirus (HPV) and Epstein-Baar Virus (EBV) infections are also related as risk factors for PC. The overexpression of p16INK4a is a surrogate sensitive marker of HPV infection in PC. OBJECTIVES: To correlate p16INK4a overexpression and HPV infection status with EBV infection in a series of PC patients from the Amazon region. METHODS: Tumor tissues from 47 PC cases were analyzed for the presence of HPV and EBV DNA by PCR. All PC patients were diagnosed between 2013 and 2018 at a public reference cancer center hospital in Manaus, Amazonas-Brazil. HPV was genotyped using E7 HPV16/HPV18 type-specific real-time PCR and the PapilloCheck® HPV-Screening assay. p16INK4a expression was evaluated by immunohistochemistry using the automated Ventana® BenchMark Ultra. RESULTS: The mean age of patients at the time of diagnosis was 57.4 years ±SD 17.8 ranging from 20 to 90 years old. Most of the patients (64%) came from rural areas of the Amazonas State. Thirty patients had phimosis (64%). Among the patients with phimosis, 43% (13/30) underwent circumcision, three during childhood and 10 in adulthood. 60% of the patients were smokers or ex-smokers. HPV infection was observed in 45% (21/47) of cases. HPV16 was detected in 13 patients (61%). Other HPV types detected were HPV 6, 11, 42, 51, 53, 68 and 44/55. EBV infection was observed in 30% (14/47) of the patients with PC. Co-infection with HPV and EBV was observed in 28% (6/21) cases. p16INK4a was only investigated in 26 samples. The p16INK4a overexpression was observed exclusively in HPV 16 positive cases and four HPV negative cases. In the survival analysis, the follow-up time was 35.4 months/patient. The mortality rate during the follow up time was 38%. CONCLUSIONS: p16INK4a positivity presented a high correlation to HPV 16 DNA detection, reinforcing its use as a surrogate marker for HPV-driven cancers. Infection with EBV was quite frequent and its role in epithelial penile oncogenesis needs to be demonstrated.


Assuntos
Inibidor p16 de Quinase Dependente de Ciclina/genética , Infecções por Vírus Epstein-Barr/complicações , Papillomaviridae , Infecções por Papillomavirus/complicações , Neoplasias Penianas/etiologia , Neoplasias Penianas/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , DNA Viral/genética , DNA Viral/isolamento & purificação , Infecções por Vírus Epstein-Barr/virologia , Marcadores Genéticos , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/isolamento & purificação , Papillomavirus Humano 16/genética , Papillomavirus Humano 16/patogenicidade , Papillomavirus Humano 18/genética , Papillomavirus Humano 18/patogenicidade , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Papillomaviridae/genética , Papillomaviridae/patogenicidade , Infecções por Papillomavirus/genética , Infecções por Papillomavirus/virologia , Neoplasias Penianas/epidemiologia , Fatores de Risco , Regulação para Cima , Adulto Jovem
14.
Int J Hematol ; 112(2): 193-199, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32472530

RESUMO

Posttransplant lymphoproliferative disorder (PTLD) after allogeneic hematopoietic cell transplantation (HCT) is usually donor derived, associated with Epstein-Barr virus (EBV), and of B-cell origin. T-cell PTLD (T-PTLD) after allogeneic HCT is extremely rare. Four of 1015 (0.39%) allogeneic HCT patients were diagnosed with T-PTLD; peripheral T-cell lymphoma-not otherwise specified, anaplastic large cell lymphoma, monomorphic T-cell PTLD and polymorphic PTLD with chronic active EBV infection-like symptoms. Three of the four patients developed T-PTLD within 6 months after HCT from HLA-mismatched unrelated donor. Three (75%) and 4 (100%) cases were positive for EBV-encoded small RNA in situ hybridization and EBV-DNA load in peripheral blood, respectively. Chimerism analysis showed that 75% of T-PTLD tissues (3/4) were recipient derived. T-PTLD was refractory to salvage chemotherapy and fatal in all four patients. Including the 10 patients in the literature, the median interval from HCT to diagnosis of T-PTLD was 5 months (range 1-72 months), 55% were negative for EBV, and 56% were recipient-derived. T-PTLD, which often occurred early after allogeneic HCT, was more likely to be EBV negative and recipient derived than B-cell PTLD after allogeneic HCT. Like T-PTLD after solid organ transplant, T-PTLD after allogeneic HCT demonstrated morphological heterogeneity and poor prognosis.


Assuntos
Infecções por Vírus Epstein-Barr/complicações , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transtornos Linfoproliferativos/etiologia , Linfócitos T , Criança , Pré-Escolar , DNA Viral/sangue , Infecções por Vírus Epstein-Barr/diagnóstico , Infecções por Vírus Epstein-Barr/virologia , Feminino , Herpesvirus Humano 4 , Humanos , Hibridização In Situ , Lactente , Masculino , Prognóstico , Transplante Homólogo , Carga Viral
15.
J Cancer Res Ther ; 16(1): 167-169, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32362630

RESUMO

Lymphoproliferative malignancies can involve both nodal- and extra-nodal tissues. The most common extranodal site involved is the gastrointestinal (GI) tract, and it is secondary to the widespread primary nodal disease. However, about 33% of non-Hodgkin's lymphoma primarily arise from tissues other than lymph nodes, spleen, or bone marrow, for example, GI tract, skin, or the central nervous system and are called primary extranodal lymphomas. The most common site of GI localization is stomach (50%-60%) followed by small bowel. Primary colonic lymphoma is seen only in 6% of GI lymphomas and up to 0.5%-1% of all colon malignancies. Hence, primary GI lymphoma is extremely rare, and primary colonic lymphoma is an even rarer occurrence. There is clearly a paucity of cases reported in literature resulting in unclear treatment protocol. Here, we report a case of a 51-year-old man who presented with abdominal pain, weight loss, and bright red blood per rectum. A colonoscopy revealed diffuse bleeding ulcers involving the entire colon. Pathology was consistent with primary diffuse large B-cell lymphoma arising from the colon. The patient was started on treatment with rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone.


Assuntos
Neoplasias do Colo/virologia , Infecções por Vírus Epstein-Barr/complicações , Hemorragia Gastrointestinal/virologia , Herpesvirus Humano 4/isolamento & purificação , Linfoma Difuso de Grandes Células B/virologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/patologia , Infecções por Vírus Epstein-Barr/virologia , Hemorragia Gastrointestinal/tratamento farmacológico , Hemorragia Gastrointestinal/patologia , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/patologia , Masculino , Prognóstico
16.
J Oral Pathol Med ; 49(7): 693-700, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32428250

RESUMO

INTRODUCTION: The role of viral infections in the pathogenesis of autoimmune diseases has long been suggested, but little evidence is available. OBJECTIVE: This study aimed to evaluate an association between EBV and CMV and the presence of rheumatoid arthritis and its association with Sjögren's Syndrome. PATIENTS AND METHOD: A case-control study was performed with 227 patients divided in RA (n = 99), RA/SS (n = 20), and C (n = 128). Resting salivary flow rate and Schirmer's test were performed; minor salivary gland biopsy was indicated in the case of suspected Sjögren's syndrome. CMV and EBV viral loads were quantified in peripheral blood, and their presence in glandular tissue samples was evaluated by in situ hybridization (EBV) and immunohistochemistry (CMV). RESULTS: EBV was more frequent in RA and RA/SS than in C (P < .000007). No correlation with clinical markers (P > .05) or between RA and RA/SS was found (P > .05). A higher number of EBV/DNA copies were found in RA (158.52 copies/µL) and RA/SS (99.24 copies/µL) (P = .739). EBV/DNA was associated with the Schirmer test (P = .0231). CMV was detected in one patient of the RA group. None of the viruses were detected in biopsies of minor salivary glands. CONCLUSIONS: Detection of EBV/DNA in peripheral blood was associated with RA regardless of the presence of SS.


Assuntos
Artrite Reumatoide/virologia , Infecções por Citomegalovirus/complicações , Infecções por Vírus Epstein-Barr/complicações , Síndrome de Sjogren/virologia , Carga Viral , Artrite Reumatoide/complicações , Estudos de Casos e Controles , DNA Viral/sangue , Herpesvirus Humano 4 , Humanos , Síndrome de Sjogren/complicações
18.
Med Hypotheses ; 142: 109826, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32416415

RESUMO

The new coronavirus infection COVID-19 has quickly become a global health emergency. Mortality is principally due to severe Acute Respiratory Distress Syndrome (ARDS) which relays only on supportive treatment. Numerous pathological, clinical and laboratory findings rise the similarity between moderate to severe COVID-19 and haemophagocytic lymphohistiocytosis (HLH). Etoposide-based protocol including dexametasone is the standard of care for secondary HLH. The protocol has been successfully used in HLHs that are secondary to EBV and H1N1 infections by inducing complete response and prolonged survival. These observations prompt to consider this cytotoxic therapy in HLH associated to moderately severe to severe forms of COVID-19.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Etoposídeo/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Betacoronavirus , Dexametasona/administração & dosagem , Infecções por Vírus Epstein-Barr/complicações , Humanos , Influenza Humana/complicações , Linfo-Histiocitose Hemofagocítica/complicações , Modelos Teóricos , Pandemias , Síndrome do Desconforto Respiratório do Adulto/complicações
19.
Dermatol Online J ; 26(2)2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-32239893

RESUMO

Plasmablastic lymphoma (PBL) is a rare and aggressive malignancy associated with immunosuppression and the oncogenic effects of the Epstein-Barr virus (EBV). We present an HIV-positive man with PBL that presented as ulcers and violaceous exophytic nodules on the legs. The clinical features, histologic appearance, and differential diagnosis of this malignancy are briefly reviewed.


Assuntos
Infecções por Vírus Epstein-Barr/complicações , Soropositividade para HIV/complicações , Linfoma Plasmablástico/etiologia , Diagnóstico Diferencial , Evolução Fatal , Herpesvirus Humano 4 , Humanos , Masculino , Pessoa de Meia-Idade , Linfoma Plasmablástico/diagnóstico , Linfoma Plasmablástico/patologia
20.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(2): 646-651, 2020 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-32319410

RESUMO

OBJECTIVE: To investigate the correlation of single nucleotide polymorphisms (SNPs) of IL2RA and IL-10 gene with the pathogenesis of Epstein Barr Virus associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children and the effect of correlated SNPs on the prognosis of children with EBV-HLH. METHODS: For EBV-HLH group (51 cases), EBV-associated infectious mononucleosis (EBV-IM) group (48 cases) and EBV-positive healthy children group (52 cases), the genotypes at rs2104286, rs12722489, rs11594656 of IL2RA gene and rs1800896, rs1800871 and rs1800872 of IL-10 gene were detected with the SNaPshot technique. The distribution differences of genotype frequency and allele frequency of each SNP in each group were analyzed, and the correlated SNPs were taken as the research object for survival analysis. RESULTS: the frequency of AA genotype at rs1800896 of IL-10 gene in EBV-HLH group was higher than that in IM group (58.8% vs 25.0%) and healthy control group (58.8% vs 26.9%). The frequency of A allele in EBV-HLH group was higher than that in IM group (74.5% vs 54.2%) and healthy control group (74.5% vs 57.7%). Similarly, the frequency of AA genotype at rs2104286 of IL2RA gene in EBV-HLH group was higher than that in both IM (54.9% vs 27.1%) and healthy control group (54.9% vs 25.0%). The frequency of A allele in EBV-HLH group was higher than that in both IM (70.6% vs 51.0%) and healthy control group (70.6% vs 46.2%). Kaplan-Meier survival curves of EBV-HLH children with different genotypes were not statistically significant. CONCLUSION: The polymorphism of rs1800896 in IL-10 gene and rs2104286 in IL2RA gene may be related with the incidence of EBV-HLH in children, and the AA genotype and A allele of the both sites may be the susceptible risk factors for EBV-HLH.


Assuntos
Infecções por Vírus Epstein-Barr , Herpesvirus Humano 4 , Interleucina-10/genética , Subunidade alfa de Receptor de Interleucina-2/genética , Linfo-Histiocitose Hemofagocítica , Criança , Infecções por Vírus Epstein-Barr/complicações , Humanos , Linfo-Histiocitose Hemofagocítica/virologia , Polimorfismo de Nucleotídeo Único
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