Efficacy of quantitative analysis of Epstein-Barr virus-infected peripheral blood lymphocytes by in situ hybridization of EBER1 after living-related liver transplantation: a case report.
BACKGROUND
We describe a 1-year-old female who underwent living-related liver transplantation for biliary atresia and developed Epstein-Barr virus (EBV)-related posttransplant lymphoproliferative disorder. This disorder was resolved after withdrawal of immunosuppression therapy and administration of a high dose of acyclovir.


METHODS
To quantify the extent of EBV activation and EBV load in peripheral blood, we measured the levels of EBV-infected peripheral lymphocytes by in situ hybridization (ISH) of EBV-encoded small mRNA 1 (EBER1).


RESULTS
The decline in the number of EBER1-positive lymphocytes (from 362/50,000 mononuclear cells to 0/50,000) after treatment was in accord with the patient's clinical improvement.


CONCLUSIONS
This finding showed that quantitative analysis of EBV-infected peripheral lymphocytes by ISH of EBER1 is very useful for monitoring the EBV load and response to treatment of patients with EBV-related disorders. Furthermore, ISH may become an important tool for the early diagnosis and prevention of life-threatening posttransplant lymphoproliferative disorder in posttransplant patients.
Nakazawa
Y
Y
First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Chisuwa
H
H
Ikegami
T
T
Hashikura
Y
Y
Matsunami
H
H
Ichikawa
T
T
Oh-ishi
T
T
Kawasaki
S
S
D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D006566:Herpesviridae Infections / Q000097:blood* / Q000209:etiology; D004854:Herpesvirus 4, Human / Q000378:metabolism; D006801:Humans; D017403:In Situ Hybridization; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects*; D008214:Lymphocytes / Q000821:virology*; D008232:Lymphoproliferative Disorders / Q000097:blood / Q000209:etiology / Q000821:virology; D012367:RNA, Viral / Q000097:blood*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D014184:Transplantation, Homologous; D019562:Viral Load; D014775:Virus Activation
D000998:Antiviral Agents; C099537:Epstein-Barr virus encoded RNA 1; D012367:RNA, Viral; D000212:Acyclovir