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Periodic illness associated with Epstein-Barr virus infection
J A Lekstrom-Himes1, J K Dale, D W Kingma
1NIAID, Bethesda, Maryland 20892, USA.
Summary
A teenager with a rare, persistent Epstein-Barr virus (EBV) infection experienced ongoing symptoms despite treatment. His unique immune response may protect B cells, suggesting a novel EBV infection form.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- Epstein-Barr virus (EBV) is a common human herpesvirus.
- Persistent EBV infection can lead to various clinical manifestations.
Observation:
- A 15-year-old male presented with a 13-year history of periodic fevers, lymphadenopathy, and leukocytosis.
- Virological, serological, immunohistologic, and molecular studies confirmed persistent, active EBV infection.
- Standard treatments, including acyclovir, were ineffective in altering the clinical course.
Findings:
- Comprehensive immunological studies did not reveal a defined immune deficiency syndrome.
- The patient exhibited circulating polymeric EBV-specific immunoglobulin A (IgA), typically seen in acute EBV infections.
- In vitro studies indicated that this polymeric IgA may prevent B cell infection by EBV.
Implications:
- The findings suggest a novel form of EBV infection characterized by persistent disease and a unique immune response.
- This case highlights the complex interplay between EBV and the host immune system.
- Further research is warranted to understand the pathogenesis and potential therapeutic strategies for this novel EBV infection form.