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Varna Medical Forum

Pathogenesis Of Epstein-Barr Virus Associated Infectious Mononucleosis

Tsvetelina Kostadinova, Gabriela Tsankova

Abstract

Infectious mononucleosis (IM) is a clinical syndrome that is most commonly associated with primary Epstein – Barr virus (EBV) infection. It was discovered in 1964 by electron microscopy of cells cultured from Burkitt`s lymphoma tissue by Michael Anthony Epstein and Yvonne Barr in a child from Africa. This is the first human oncogenic virus described. At present, in the international classification of viruses it is Human gammaherpesvirus 4, the fourth in order of discovery representative of this family. EBV is widespread and over 90% of the adult population in the world is infected with it. The infection is transmitted mostly by oropharyngeal secretions and because of this in the literature, IM is also referred to as the “Kissing Disease”. Initially, the virus replicates in the pharynx epithelium and then infects the lymphocytes of the underlying lymphoid tissue. Infection is spread in the whole body by circulating lymphocytes. EBV remains dormant in the B-lymphocyte population and these cells are a reservoir of the virus throughout life. The incubation period is 4-6 weeks and disease occurs with the classical triad - a fever with severe fatigue, lymphadenopathy and pharyngitis. Leukocytosis with lymphocytosis, predominantly with atypical lymphocytes, are detected during the second or third week of the disease. For serological diagnosis, antibodies against viral antigens such as anti-VCA Ig M and Ig G are positive, and antibodies to EBNA1 (EB nuclear antigen) are not seen in the acute phase of EBV infection. The connection between IM and Hodgkin's lymphomas makes IM a socially significant illness and requires accurate diagnosis supported by appropriate laboratory studies.


Keywords

EBV, infectious mononucleosis, Human gammaherpesvirus 4, EBV infection

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References

Стайс, ДП. Обща и клинична имунология, под ред. на Хр. Тасков, превод на 8-о издание; София: НЦЗПБ;1997.

Cohen, J. Epstein-Barr virus infection. N Engl J Med. 2000; 343(7):481-492.

Crawford, DH, Mcsween, KF, Higgins, CD, Thomas R, McAulay K, Williams H, et al. A cohort study among university students: identification of risk factors for Epstein-Barr virus seroconversion and infectious mononucleosis. Clin Infect Dis. 2006;43:276-82.

De Paschale M1, Clerici P. Serological diagnosis of Epstein-Barr virus infection: Problems and solutions. World J Virol. 2012; Feb 12;1(1):31-43. doi: 10.5501/wjv.v1.i1.31.

Evans AS, Niederman JC, Cenabre LC, West B, Richards VA., A Prospective Evaluation of Heterophile and Epstein-Barr Virus-Specific IgM Antibody Tests in Clinical and Subclinical Infectious Mononucleosis: Specificity and Sensitivity of the Tests and Persistence of Antibody J Infect Dis. 1975; Nov;132(5):546-54.

Henle G, Henle W, Diehl V, (Relation of Burkitt’s tumor-associated herpes-type virus to infectious mononucleosis. Proc. Natl Acad. Sci. 1968;USA, 59(1):94–101.

Ishii E, Ohga S, Imashuku S, Yasukawa M, Tsuda H, Miura I et al. Nationwide survey of hemophagocytic lymphohistiocytosis in Japan. Int J Hematol.2007;86(1):58-65.

Keymeulen, B., Vandemeulebroucke, E.,Ziegler, A.G., et al. Insulin needs after CD3-antibody therapy in new-onset type 1 diabetes.N Engl J Med. 2005;352:2598-608.

Luzuriaga K, Sullivan JL. Infectious mononucleosis. N Engl J Med., 2010;362(21):1993-2000.

Nicholas J, Jeang KT, Wu TC. Human Cancer Viruses. Principles of Transformation and Pathogenesis. Transl Res Biomed. Basel, Karger.2008; vol 1:137–149.

Odumade OA, Hogquist KA, Balfour HH. Progress and Problems in Understanding and Managing Primary Epstein-Barr Virus Infections. Clinical Microbiology Reviews. 2011;24(1):193-209.

Rickinson AB, Long HM, Palendire U, Munz C, Islop AD. Cellular immune controls over Epstein – Barr virus infection: new lessons from the clinic and the laboratory. Trend in immunology.2014; 35(4): 159-169.

Sumaya CV, Ench Y. Epstein-Barr virus infectious mononucleosis in children. I. Clinical and general laboratory findings. Pediatrics. 1985; Jun;75(6):1003-10.

Svahn, A., M Magnusson, L Jägdahl, L Schloss, G Kahlmeter, A Linde Evaluation of three commercial enzyme-linked immunosorbent assays and two latex agglutination assays for diagnosis of primary Epstein-Barr virus infection. Journal of Clinical Microbiology Nov 1997;35 (11): 2728-2732.

Williams H, Macsween K, McAulay K,Higgins C, Harrison N, Swerdlow A, et al. Analysis of Immune Activation and Clinical Events in Acute Infectious Mononucleosis. J Infect Dis. 2004; 190 (1): 53-62.

Williams H, Crawford DH. Epstein-Barr virus: the impact of scientific advances on clinical practice. Blood. 2006; 107:862-9.




DOI: http://dx.doi.org/10.14748/vmf.v7i0.6122

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