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An Efficient and Simple Method to Establish NK and T Cell Lines from Patients with Chronic Active Epstein-Barr Virus Infection
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Concomitant nephrotic syndrome and tubulointerstitial nephritis in a child with Epstein-Barr virus mononucleosis

Ratna Acharya1, Xu Zeng2, Kiran Upadhyay3

  • 1Pediatrics, University of Florida, Gainesville, Florida, USA.

BMJ Case Reports
|February 5, 2021
PubMed

Insights

Epstein-Barr virus (EBV) can cause rare kidney problems like acute kidney injury (AKI) and nephrotic syndrome (NS) in children. Steroid treatment helped a young boy recover from EBV-related kidney complications.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Immunology

Background:

  • Infectious mononucleosis (IM), typically caused by Epstein-Barr virus (EBV), is common in adolescents and young adults.
  • While IM primarily affects B lymphocytes, its association with severe renal manifestations like acute kidney injury (AKI) and nephrotic syndrome (NS) is infrequent.

Observation:

  • A 4-year-old boy presented with severe AKI requiring dialysis and NS during IM.
  • Renal biopsy revealed acute tubular necrosis and podocyte injury, but EBV early RNA was undetectable in kidney tissue.
  • Peripheral lymphocyte analysis indicated heightened cytotoxic T cell activity and an increase in memory B cells.

Findings:

  • Steroid therapy resulted in rapid resolution of NS within three weeks, with stabilization of renal function.
  • Serological markers confirmed a primary EBV infection, with a characteristic pattern of antibody development over four months.
  • The study suggests that EBV-induced immune responses, involving B and T lymphocytes, may contribute to kidney damage.

Implications:

  • This case highlights EBV as a potential cause of severe renal disease in children, necessitating prompt diagnosis and management.
  • Understanding the immunopathogenesis of EBV-related kidney injury can inform treatment strategies for similar cases.
  • Further research into the role of lymphocyte subsets in EBV-associated nephropathies is warranted.
Keywords:
acute renal failuredialysisinfectionsnephrotic syndromepaediatrics (drugs and medicines)

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