Demonstration of Epstein-Barr virus DNA in a previously healthy boy with fulminant hepatic failure

Deutsch, J.; Wolf, Hans; Becker, H; Fuchs, B; Goriup, U; Grubbauer, H. M.; Muntean, W; Popow‐Kraupp, Therese; Stünzner, D

doi:10.1007/bf00441865

Cited by 12 publications

(6 citation statements)

References 19 publications

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“…There is a tendency to more chronic courses lasting several months, in par ticular for older patients. The reason for rare fatal cases where virus replication has been detected in the liver is unclear [Deutsch et al, 1986], A clear gentic factor is involved in Duncan syndrome where a locus of the X chromosome determines a fatal outcome of EBV infection [Purtilo et al, 1975;Skare et al, 1987]. 75% of males die from fatal IM, the remainder die from a variety of EBV-related conditions, mostly of B-cell lymphomas; 70% die by 10 years of age, 100% are dead by 40 years.…”

Section: Discussionmentioning

confidence: 99%

Epstein-Barr Virus and Its Interaction with the Host

1993

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Epstein-Barr virus (EBV) as a member of the herpesvirus family persists lifelong in the human body and causes diseases associated with virus replication (infectious mononucleosis, oral hairy leukoplakia) as well as neoplastic conditions such as nasopharyngeal carcinoma, B-cell lymphoma, Hodgkin’s disease associated with viral latency. This complex biology relates to a highly regulated control of the persisting virus. Still, EBV is lytically produced in certain compartments of the human body. Epithelial cells were found to be of key importance for this. Various routes (cell fusion, IgA receptor-mediated uptake) were described for EBV to enter epithelial cells in the absence of CR2 receptor. Viral entry into cells, however, via CR2 receptor fusion or IgA mediated was not found to be sufficient for viral production. The molecular mechanisms for the lack of viral production in most target cells are primarily the presence of silencer activities and the early elimination of cells entering the lytic cycle. Only terminally differentiated epithelial cells are capable of supporting an efficient lytic cycle of EBV replication. EBV-mediated suppression of apoptosis as well as down-regulation of cellular and viral gene products, such as HLA molecules, which mediate recognition by the immune system, are important contributing factors to the development of these neoplasias where viral genes, possibly via interaction with anti-oncogenes, such as p53, in context with genetic and environmental factors play a key role. Novel diagnostic tools and a vaccine have been developed which could help to control EBV-related diseases.

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Section: Discussionmentioning

confidence: 99%

Epstein-Barr Virus and Its Interaction with the Host

1993

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“…. The median age of patients is 13 years with a male-to-female ratio of 1.3 to 1 (38). The median survival time after the onset of SFIM is approximately 4 weeks with a range of 1-100 weeks (37).…”

Section: Sporadic Fatal Infectious Mononucleosismentioning

confidence: 99%

Manifestations of Epstein‐Barr virus‐associated disorders in liver

Markin¹

1994

Liver

113

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Epstein‐Barr virus is a ubiquitous virus associated with a variety of different diseases and disorders. The manifestations of Epstein‐Barr virus‐associated diseases or disorders within the liver, which involve a broad spectrum of histologic and clinical features, ranging from hepatitis through lymphoproliferative disorders to lymphoma, are presented. An important aspect of Epstein‐Barr virus expression and infection is the biology of the Epstein‐Barr virus. Documentation of infection can be performed using serology to detect the interaction of Epstein‐Barr virus with the immune system, and the detection of EBV proteins and use of molecular biologic techniques to identify the presence of EBV RNA, and DNA sequences. Of particular utility are in situ hybridization, Southern blot analysis, and polymerase chain reaction as diagnostic methods to identify specific RNA or DNA sequences. Epstein‐Barr virus‐associated diseases and disorders including infectious mononucleosis, sporadic fatal infectious mononucleosis, X‐linked proliferative disorder (Duncan's disease), post‐transplant lymphoproliferative disorders, lymphoma, and AIDS are discussed. The histopathologic findings present in liver associated with each disease are presented with illustrative examples. Handling the tissue and interaction with clinical services are also discussed as a method for appropriate diagnosis of Epstein‐Barr virus‐driven processes affecting the liver.

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“…Generally, only a mild, subclinical elevation in transaminase levels occurs; however, there are a few case reports of fulminant hepatic failure associated with EBV (29)(30)(31). Histological, periportal lymphoid infiltrates are noted, without evidence of direct infection of the hepatic parenchymal cells (32).…”

Section: Discussionmentioning

confidence: 99%