The Viruses
Julius P. Kreier in Infection, Resistance, and Immunity, 2022
“Kissing disease” is one name for an acute illness of adolescents and young adults referred to more correctly as infectious mononucleosis. Lymphadenopathy, mild hepatitis, abnormal mononuclear lymphocytes, and large amounts of heterophile antibodies in the blood characterize the disease, infectious mononucleosis is caused by the Epstein-Barr virus, a member of the Herpesviridae (Table 16.1). Epstein-Barr virus is transmitted with infectious body fluids, most commonly saliva. The virus is lymphotropic, infecting B cells. Primary infection in early childhood is usually asymptomatic, but thirty to fifty percent of individuals infected in early adolescence develop clinical disease. Most people possess antibodies to Epstein-Barr virus, indicating prior exposure, but only about fifteen percent of seropositive persons shed virus in the saliva.
Introduction
Jay A. Goldstein in Chronic Fatigue Syndromes, 2020
During the six years or so that I have been intensely interested in chronic fatigue syndrome (CFS), my understanding of the illness has undergone continued evolution. I originally conceived of CFS as being a disorder of inappropriate immune activation with the symptoms caused by generation of immune transmitter substances called cytokines. I developed this concept from earlier work on the treatment of acute infectious mononucleosis with H-2 blockers, the results of which I published in 1981 and 1983.1,2 Mononucleosis had been discovered to be caused by the Epstein-Barr virus (EBV) and it was known at the time that there was an elevated number of OKT8+ cells, now called suppressor/cytotoxic, or CD8+, cells. Although the symptoms were systemic and constitutional, and included fatigue, sore throat and obvious tonsillitis with enlarged lymph nodes and enlarged spleen, the Epstein-Barr virus could be recovered from only a few locations, such as the oropharynx. It seemed rather obvious that most of the signs and symptoms were caused by the reaction of the immune system to the virus, rather than the virus itself. Having a background in psychopharmacology, in which the study of transmitter-receptor interactions was fairly advanced, I reasoned that the OKT8+ lymphocytes might be producing a factor that was causing the syndrome. Cytokines or lymphokines were not well known yet, and the idea that cytokine dysrecould could cause disease was novel.
Pharynx, Larynx and Neck
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
Investigation This is by direct inspection with a flexible or rigid nasendoscope and biopsy under topical or general anaesthesia. Serological investigation for Epstein-Barr virus-associated antigenic markers in combination with the clinical and histological examination is valuable for the early detection of disease. Highly sensitive assays for antiviral antibodies together with virus-associated serological markers are useful in early detection and in post-treatment surveillance. Immunoglobulin (Ig) A antiviral capsid antigen antibody and early antigen antibody have been evaluated in mass surveys in southern China and have been found to be an excellent screening method for early detection of nasopharyngeal carcinoma in high-risk groups.
Genital ulceration in adolescent girls: a diagnostic challenge
Published in Journal of Obstetrics and Gynaecology, 2021
Anastasia Vatopoulou, Konstantinos Dinas, Evangelia Deligeoroglou, Alexis Papanikolaou
Acute vulvar ulceration in children and non-sexually active adolescents is rare and presents as single or multiple painful ulcers with necrotic margins that usually resolve without scarring. In addition to sexually transmitted infections (STIs), it can be caused by several conditions such as autoimmune diseases (Behçet’s disease (BD)), fixed drug reactions or Crohn’s disease. Infections by viruses, mycoplasma and toxoplasma have been implicated in some cases (Vismara et al. 2020). The Epstein-Barr virus (EBV) causes infectious mononucleosis, one of the commonest viral infections in humans (Masucci and Ernberg 1994). Most of the population in developed countries acquire immunity to EBV during childhood and adolescence (Schuster and Kreth 1992). Genital ulcerations have been associated with EBV infection and appear to represent a manifestation of a systemic viraemia (Sumaya 1986).
Who is the patient at risk for EBV reactivation and disease: expert opinion focused on post-transplant lymphoproliferative disorders following hematopoietic stem cell transplantation
Published in Expert Opinion on Biological Therapy, 2023
Agata Marjanska, Jan Styczynski
Epstein-Barr virus is associated with various diseases [7,17,18]. EBV-associated clinical syndromes include: Primary syndromes: infectious mononucleosis (IM), chronic active EBV infection (CAEBV), hemophagocytic lymphohistiocytosis (HLH), X-linked lymphoproliferative syndrome;EBV-associated tumors: lymphoproliferative disorders (LPD, non-PTLD), Burkitt lymphoma, EBV-positive DLBCL (Diffused Large B-Cell Lymphoma), nasopharyngeal carcinoma, EBV-associated smooth muscle tumors, T/NK (T-Cell/Natural Killer Cell) lymphomas, Hodgkin lymphoma, angioimmunoblastic T-cell lymphoma;EBV-associated post-transplant diseases: post-transplant lymphoproliferative disorders (PTLD), post-transplant hemophagocytic lymphohistiocytosis (HLH), oral hairy leukoplakia, and other rare end-organ diseases: encephalitis, myelitis, hepatitis, pneumonia, etc.
Clinical characteristics and prognostic factors in Chinese patients with classical Hodgkin’s lymphoma involving extranodal sites: a retrospective single-center
Published in Hematology, 2019
Dong-Mei Zou, Dao-Bin Zhou, Yan Zhang, Wei Wang, Wei Zhang
Sixty-eight (47.2%) of 144 cHL patients had extranodal involvement at diagnosis. Characteristics of 68 Patients with extranodal involvement and 76 patients with only nodal involvement are shown in Table 1. Of the 68 patients with extranodal involvement, 42 (61.8%) were male. The median age was 31 (15−79) years, with 16 (23.5%) patients older than 45 years. Five patients presented with bulky disease and 44 with B symptoms. Almost all patients (61 of 68, 89.7%) were at advanced stage (stage II with bulky disease, stage III and IV). Serum lactate dehydrogenase (LDH) levels were elevated in 21 (30.9%) patients, and 21 had lymphocytopenia. Based on the international prognostic score (IPS) [9], 27 (39.7%) patients were classified into a low-risk group (IPS < 3) and 41 (60.3%) into a high-risk group (IPS ≥ 3). Most (44 of 68, 66.2%) patients had ≥4 lymph node regions (LNR) involved (definition of lymph node regions was based on Ann Arbor Stage [10]). Three patients were Hepatitis B surface antigen positive and none was human immunodeficiency virus positive. Of the 30 patients detecting Epstein–Barr virus DNA, 8 had positive results. In patients with extranodal involvement, advanced stage, B symptoms, low serum albumin, lymphocytopenia and ≥4 LNR involved were more common than those in patients with only nodal involvement. Other clinical characteristics of patients with extranodal involvement, such as age, gender and pathological type, showed no significant difference in comparison with those of patients with only nodal involvement.
Related Knowledge Centers
- Burkitt Lymphoma
- Hemophagocytic Lymphohistiocytosis
- Herpesviridae
- Oncovirus
- Precancerous Condition
- Virus
- Hodgkin Lymphoma
- Infectious Mononucleosis
- Vaccine
- Epstein–Barr Virus–Associated Lymphoproliferative Diseases