Epstein-Barr virus in the bone marrow of patients with aplastic anemia.
OBJECTIVE
To determine whether Epstein-Barr virus is present in the bone marrow of patients with aplastic anemia.


METHODS
Assay of fresh and fixed bone marrow specimens for Epstein-Barr virus using immunofluorescence for nuclear antigen, Southern analysis with an Epstein-Barr virus specific probe, and in-situ hybridization.


METHODS
Governmental medical referral center.


METHODS
Five patients were studied prospectively: three who previously had infectious mononucleosis, one with a recent viral pneumonitis, and one who was asymptomatic. Stored DNA samples from other patients with aplastic anemia were also screened.


RESULTS
Epstein-Barr virus DNA and protein were detected in the bone marrow of 5 patients studied prospectively and in 1 of 40 patients studied retrospectively. As estimated by in-situ hybridization, about 3% to 5% of marrow cells were infected with virus in those patients who had not received acyclovir. In contrast, Epstein-Barr virus DNA was not detected in peripheral blood DNA of these patients, nor were Epstein-Barr virus proteins or DNA found in the bone marrow of normal donors, patients with other hematologic diseases, or in 1 patient with acute infectious mononucleosis. Analysis of DNA fragments by hybridization with Epstein-Barr virus probes showed a pattern dissimilar to the type of Epstein-Barr virus usually associated with infectious mononucleosis.


CONCLUSIONS
Aplastic anemia may be associated with Epstein-Barr virus more commonly than suspected by history. Localization of the virus in the bone marrow supports a causative role for Epstein-Barr virus in bone marrow failure.
Baranski
B
B
National Institutes of Health, Bethesda, Maryland.
Armstrong
G
G
Truman
J T
JT
Quinnan
G V
GV
Straus
S E
SE
Young
N S
NS
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000209:etiology / Q000382:microbiology*; D000914:Antibodies, Viral / Q000032:analysis; D000956:Antigens, Viral / Q000032:analysis; D015139:Blotting, Southern; D001853:Bone Marrow / Q000382:microbiology*; D004279:DNA, Viral / Q000032:analysis; D019309:Epstein-Barr Virus Nuclear Antigens; D005260:Female; D005455:Fluorescent Antibody Technique; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007244:Infectious Mononucleosis / Q000150:complications; D008297:Male; D009693:Nucleic Acid Hybridization; D011446:Prospective Studies; D012189:Retrospective Studies
D000914:Antibodies, Viral; D000956:Antigens, Viral; D004279:DNA, Viral; D019309:Epstein-Barr Virus Nuclear Antigens