Epstein-Barr virus infections in males with the X-linked lymphoproliferative syndrome.
A registry of persons with the X-linked lymphoproliferative syndrome, which is characterized by marked susceptibility to diseases induced by the Epstein-Barr virus, has enrolled 161 patients within 44 kindreds. Fifty-seven percent of the males died of infectious mononucleosis, 29% developed acquired hypogammaglobulinemia, and 24% had malignant lymphoma. The mortality rate was 80%; 70% died by 10 years of age and 100% by 40 years. Thirty-two boys survive, most with malignant lymphoma, acquired hypogammaglobulinemia, or both. We hypothesized that the defective lymphoproliferative control locus on the X chromosome results in unregulated cytotoxic lymphocytic responses to the Epstein-Barr virus; hence, severe hepatitis and virus-associated hemophagocytic syndrome occur with the infectious mononucleosis phenotype. T-cell suppression of immunoglobulin secretion by B cells is responsible for acquired hypogammaglobulinemia. A sustained polyclonal B-cell proliferation probably converts to a monoclonal B-cell malignancy as a result of molecular alterations.
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006579:Heterozygote; D006801:Humans; D007223:Infant; D008232:Lymphoproliferative Disorders / Q000453:epidemiology / Q000235:genetics* / Q000276:immunology; D008297:Male; D010587:Phagocytosis; D010641:Phenotype; D013577:Syndrome; D014960:X Chromosome
D000914:Antibodies, Viral