title: Polyclonal proliferation of lymphocytes containing the epstein-barr virus genome in a patient dying of myocarditis in chronic active Epstein-Barr virus infection.
abstract: An 11-year-old boy had intermittent fever and hepatosplenomegaly. The diagnosis of chronic active Epstein-Barr virus (EBV) infection was established from an abnormal pattern of anti-EBV antibody; EBV was detected in bone marrow cells. Immunochemotherapy alleviated the patient's symptoms. However, when a subsequent oral prednisolone dose was tapered, heart failure ensued and he died. Autopsy findings demonstrated that myocarditis resulted from infiltrating T lymphocytes with the EBV genome and a benign histologic appearance. A clonality study of T lymphocytes indicated no such evidence of monoclonality. EBV-infected T cells play an important role in the pathogenesis of myocarditis in chronic active EBV infection.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. mamisuke@h.do-up.com
authors.forename: Mami
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimozono
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ono
authors.forename: Naoto
authors.initials: N
authors.lastname: Fujita
authors.forename: Shinichirou
authors.initials: S
authors.lastname: Nishimura
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ueda
authors.forename: Mayumi
authors.initials: M
authors.lastname: Kaneko
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D019309:Epstein-Barr Virus Nuclear Antigens / Q000276:immunology; D017809:Fatal Outcome; D016679:Genome, Viral; D004854:Herpesvirus 4, Human / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008099:Liver / Q000473:pathology; D008213:Lymphocyte Activation; D008297:Male; D009205:Myocarditis / Q000209:etiology* / Q000276:immunology*; D011239:Prednisolone / Q000627:therapeutic use; D013601:T-Lymphocytes / Q000821:virology*; D017211:Treatment Failure
chemical_list: D018931:Antineoplastic Agents, Hormonal; D019309:Epstein-Barr Virus Nuclear Antigens; D011239:Prednisolone