Central nervous system vasculitis from Epstein-Barr virus-associated T/natural killer-cell lymphoproliferative disorder in children: A case report

Lee, Mi Seon; Hwang, Su-Kyeung; Kim, Yeong Eun; Suh, Jin Kyung; Kim, Hyery; Lee, So Mi; Jeong, Ji Yun; Kwon, Soonhak; Lee, Yun Jeong

doi:10.1016/j.braindev.2019.05.009

Cited by 7 publications

(3 citation statements)

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“…1,2 It has been reported that EBV is associated with various forms of vasculitis, such as Kawasaki disease, rheumatoid vasculitis, central nervous system vasculitis, and cutaneous necrotizing vasculitis. [3][4][5][6] Henoch-Schönlein purpura (HSP) is the most common vasculitis in children characterized by palpable purpura, arthritis, gastrointestinal symptoms, and renal involvement. Infections may be one of the several possible triggers participating in its pathogenesis.…”

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confidence: 99%

Epidemiology and Clinical Characteristics of Henoch-Schönlein Purpura Associated With Epstein-Barr Virus Infection

Hu¹,

Jian-gang²,

Cheng³

et al. 2021

Mediterr J Hematol Infect Dis

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Introduction: Henoch-Schönlein purpura (HSP) is an immune-mediated vasculitis, and the formation of immune complexes may be triggered by exposure to Epstein-Barr virus (EBV) infection. Methods: We performed a five-year case-control study to evaluate the epidemiology and clinical characteristics of HSP associated with EBV infection. Results: The incidence of EBV-triggered HSP was 4.2%, while EBV infection in children with HSP was 0.9%; The EBV-triggered HSP cases had a significantly higher frequency of abdominal pain than the MP-triggered HSP group (χ2 = 8.024, p = 0.005); Significant differences were observed in the duration of abdominal pain (Z = -1.935, p = 0.027) between the two groups; C3 (t = 9.709, p < 0.001), IgA (t = 20.39, p < 0.001) and IgG (t = 6.407, p < 0.001) were significantly increased in the EBV infection group than those in the healthy control group. Notably, significantly higher proportion of CD19 (t = 6.773, p < 0.001) and lower proportion of CD56 (t = 11.13, p < 0.001) was found in EBV infection group compared with healthy control group. The IgA level was higher than that of the non-infectious group (t = 2.162, p = 0.032), but their CD4/CD8 ratio (t = 10.070, p < 0.001) and CD56 proportion (t = 2.096, p = 0.037) were significantly lower. Conclusions: Both cellular and humoral immunity were involved in the pathogenesis of EBV-triggered HSP, leading to increased production of inflammatory mediators and immunoglobulins. Those events may cause or promote the development of systemic vessel vasculitis.

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confidence: 99%

Epidemiology and Clinical Characteristics of Henoch-Schönlein Purpura Associated With Epstein-Barr Virus Infection

Hu¹,

Jian-gang²,

Cheng³

et al. 2021

Mediterr J Hematol Infect Dis

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“…Initially, 1998 records were retrieved from electronic databases and manual reference searches. After removing duplicates and the studies that did not meet the inclusion criteria, 61 articles (n = 271) were finally included (Figure ) 7,8,16,19,26–82 . After including 18 patients from the Asan Medical Center database, a total of 289 patients were identified.…”

Section: Resultsmentioning

confidence: 99%

Clinicopathological and prognostic study of primary cutaneous extranodal natural killer/T‐cell lymphoma, nasal type: A systematic review

Jung

Yang

Won

et al. 2021

The Journal of Dermatology

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Comprehensive studies of primary cutaneous extranodal natural killer/T‐cell lymphoma (PCENKTL) are scarce. The objectives of this study are to describe PCENKTL in terms of its clinical features, histopathology, immunophenotypes, and prognosis, and to analyze factors affecting patient survival outcomes. We searched four databases and include studies with extractable data. We also searched the Asan Medical Center database for cases of PCENKTL. We include a total of 289 patients. The mean age at diagnosis was 52.8 years and the female to male ratio was 1:1.2. The most common clinical morphology was a subcutaneous nodule, followed by ulceration. About half of the patients presented with disseminated skin lesions. The median overall survival was 12.0 months and the 5‐year survival rate was 22.0%. There was no correlation between the clinical morphology or the histopathological features of the skin lesions with the patient outcomes. Advanced TNM stage, a disseminated skin lesion, tumor location on the leg or trunk, the presence of B symptoms, and a high International Prognostic Index score were associated with a worse prognosis, and chemoradiotherapy was associated with a better survival outcome as compared with chemotherapy alone in univariable analyses. In multivariable analyses, only advanced TNM stage and tumor location on the leg were associated with a worse prognosis. In conclusion, PCENKTL is an aggressive cutaneous lymphoma and its prognosis is associated with TNM stage and tumor location.

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“…39 Vasculitis: Central nervous system (CNS) vasculitis in addition to myelopathy are considered neurologic symptoms of EBV -T / natural killer -cell lymphoproliferative disordered affecting children. 40 Also, Kawasaki disease (KD) which is an acute systemic vasculitis in addition to other signs could be triggered by EBV. 41…”

Section: Infectious Mononucleosis (Im)mentioning

confidence: 99%

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2021

JHVRV

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Epstein Barr virus (EBV) was detected for the first time by electron microscopy (EM) in a malignant Burkitt's lymphoma. EBV has a worldwide distribution and its prevalence is more than 90%. It is a malignant virus, symptoms vary from mild or find no symptoms in some individuals and serious symptoms or cancers in others. EBV is a characteristic one since it has a lot of properties to become latent and modulate the host immune system in a serious manner in some conditions where it has many proteins having sequence and functional homology with many human proteins. EBV could be transmitted through saliva or contact with the air borne, blood transfusion, organ transplantation semen or cervical secretions. EBV Causes a lot of diseases which varies according to some factors. Rediagnosis For COVID-19 is recommended by considering it EBV or ovine herpes virus 2 (OvHV-2) where I think that they are the same virus With two names according to human or veterinary medicine because accurate diagnosis is the first and most important step for controlling COVID-19 and I show that the obtained RNA and considered as corona Virus is mainly one of the messenger RNA (s) of EBV (0vHV-2) to be translated for proteins demanded by this herpesvirus. This false diagnosis may be performed with other RNA viruses named previously. Proper diagnosis will be achieved by electron microscopy for detection of herpes viral particles and sequencing of glycoprotein B complete gene. Another recommendation is taking in consideration that stool is among routes of infection as well as milk and colostrum with special care during management for all animals or birds ( because all species are susceptible ) which also give good chance for experimental application of vaccines, antibodies as well as studying pathogenesis and pathology of the virus.

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Central nervous system vasculitis from Epstein-Barr virus-associated T/natural killer-cell lymphoproliferative disorder in children: A case report

Cited by 7 publications

References 9 publications

Epidemiology and Clinical Characteristics of Henoch-Schönlein Purpura Associated With Epstein-Barr Virus Infection

Epidemiology and Clinical Characteristics of Henoch-Schönlein Purpura Associated With Epstein-Barr Virus Infection

Clinicopathological and prognostic study of primary cutaneous extranodal natural killer/T‐cell lymphoma, nasal type: A systematic review

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