Investigation of EB virus and cytomegalovirus in rapidly progressive interstitial pneumonitis in polymyositis/dermatomyositis by in situ hybridization and polymerase chain reaction.
In polymyositis/dermatomyositis (PM/DM), a rapidly progressive interstitial pneumonitis (RPIP) which is a fatal complication of unknown etiology has received increasing attention. We have encountered 9 RPIP cases among 150 PM/DM cases in the past 10 years. To investigate the pathogenic role of viruses in RPIP, we examined lung specimens from patients with RPIP in PM/DM for the presence of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) using polymerase chain reaction (PCR) and in situ hybridization (ISH). We analyzed 21 specimens from RPIP in PM/DM (n = 9), collagen diseases (n = 6; 4 had interstitial lung disease), and controls (n = 6). EBV was frequently detected in RPIP (7/9 by PCR 3/9 by ISH), but was also detected in other collagen diseases of the lungs. In lung specimens from both patients with RPIP in PM/DM and those with collagen diseases, EBV was significantly detected (13/15 by PCR, 5/15 by ISH, P < 0.005) compared to controls (1/6 by PCR, 0/6 by ISH). CMV was detected by ISH in 2 RPIP patients but in none of he others, though by PCR CMV was detected equally in the three groups studied. These findings indicate that a direct involvement of EBV or CMV in RPIP of PM/DM is unlikely, although it is possible that an immune response to latent viruses or viral products in PM/DM may have a role in the pathogenesis of the RPIP.
Hashimoto
Y
Y
Second Department of Internal Medicine, School of Medicine, Chiba University, Japan.
Nawata
Y
Y
Kurasawa
K
K
Takabayashi
K
K
Oda
K
K
Mikata
A
A
Iwamoto
I
I
D000328:Adult; D000368:Aged; D001483:Base Sequence; D015139:Blotting, Southern / Q000379:methods; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D017931:DNA Primers / Q000737:chemistry; D004279:DNA, Viral / Q000032:analysis / Q000302:isolation & purification; D003882:Dermatomyositis / Q000150:complications; D005260:Female; D006566:Herpesviridae Infections / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D017403:In Situ Hybridization; D008168:Lung / Q000821:virology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009220:Myositis / Q000150:complications* / Q000628:therapy; D011024:Pneumonia, Viral / Q000821:virology*; D016133:Polymerase Chain Reaction; D017285:Polymyositis / Q000150:complications
D017931:DNA Primers; D004279:DNA, Viral