Cardiovascular complications associated with chronic active Epstein-Barr virus infection
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Updated: Jun 26, 2026
An Efficient and Simple Method to Establish NK and T Cell Lines from Patients with Chronic Active Epstein-Barr Virus Infection
Published on: March 30, 2018
Jun Muneuchi1, Shouichi Ohga, Masataka Ishimura
1Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Insights
Chronic active Epstein-Barr virus infection (CAEBV) frequently leads to severe cardiovascular diseases, including coronary artery lesions, in children and adolescents. Eradicating EBV-infected cells is crucial for managing cardiac complications in CAEBV patients.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Immunology
Background:
- Chronic active Epstein-Barr virus infection (CAEBV) is a rare condition with significant morbidity.
- Cardiovascular complications in CAEBV are not well-characterized.
- Early identification and management of cardiac issues are vital for patient outcomes.
Purpose of the Study:
- To evaluate the incidence and spectrum of cardiovascular diseases in patients with CAEBV.
- To identify clinical features associated with cardiac complications in CAEBV.
- To assess the outcomes of cardiac involvement in CAEBV.
Main Methods:
- Retrospective analysis of 15 patients diagnosed with CAEBV.
- Regular cardiologic assessments including echocardiography and ECG.
- Correlation of clinical symptoms and laboratory findings with cardiac outcomes.
Main Results:
- 60% of CAEBV patients developed cardiac diseases, most commonly coronary artery lesions (CAL).
- Fever and cytopenias were more frequent in patients with cardiac complications.
- CAL was the most common cardiac complication, and 78% of affected patients died.
- CAL regression was observed in two patients post-allogeneic cord blood transplantation.
Conclusions:
- Cardiovascular diseases, particularly CAL, are a major cause of mortality in CAEBV.
- Management of cardiac complications requires addressing the underlying EBV infection.
- Eradication of EBV-infected T- and NK-cells is essential for controlling cardiac manifestations.
Abstract:
This study aimed to assess the outcome of cardiovascular diseases for patients with chronic active Epstein-Barr virus infection (CAEBV). The study enrolled 15 patients (7 boys and 8 girls) who fulfilled the diagnostic criteria for CAEBV, including 10 patients with T-cell type and 3 patients with natural killer (NK)-cell type. The median age at the CAEBV onset was 6.3 years (range, 1.2-17.8 years). Regular cardiologic studies were performed during the median follow-up period of 8 years (range, 2-20 years). Nine patients (60%) had cardiac diseases including coronary artery lesion (CAL) (n = 4, 44%), decreased left ventricular ejection fraction and pericardial effusion in (n = 3, 33%), complete atrioventricular block (n = 1), and sudden arrest (n = 1). The frequency of fever (78%, p = 0.04) or cytopenias (100%, p = 0.01), as the major symptom among patients with cardiac complications, was higher than among those without complications. The median time from disease onset to detection of CAL was 3.4 years (range, 1.8-8.6 years). The mean z-score increased to 3.98. Seven patients (78%) with cardiac complications died of disease progression, hematopoietic stem cell transplantation-related events, or both. In two patients, CAL regressed after allogeneic cord blood transplantation. Among CAEBV patients, CAL was the most common cardiac complication and could not be controlled without the eradication of EBV-infected T- and NK-cells.
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