Epstein-Barr-virus-induced interstitial lung disease.
OBJECTIVE
We describe a patient in whom Epstein-Barr virus infection appears to have caused an unusual interstitial lung disease with multisystem involvement resembling sarcoidosis and interstitial lung disease. We have reviewed the relevant literature about the relation of Epstein-Barr virus and interstitial lung disease.


RESULTS
Epstein-Barr virus replication within type II alveolar cells was shown to occur in adult cryptogenic fibrosing alveolitis. Latent membrane protein 1 is one of the Epstein-Barr-virus-associated proteins and is expressed on the surface of Epstein-Barr-virus-infected cells in the latent and replicating phases. Latent membrane protein 1 was positive in the cuboidal epithelial cells of the lungs from some patients with idiopathic pulmonary fibrosis, and that its positivity correlated with poor prognosis. Epstein-Barr virus was also found in the lungs of children with lymphocytic interstitial pneumonia, AIDS and Langerhans cell histiocytosis. Epstein-Barr virus DNA was not detectable in patients with sarcoidosis. There was also lack of evidence for a role of Epstein-Barr virus in the increase of lung cancer in idiopathic pulmonary fibrosis.


CONCLUSIONS
Using monoclonal antibodies against viral antigen Epstein-Barr virus was shown to replicate within type II alveolar cells of adult idiopathic pulmonary fibrosis patients. Latent membrane protein 1positivity indicates poor prognosis; Epstein-Barr virus positivity did not increase the incidence of lung cancer in these patients. Epstein-Barr virus was also associated with lymphocytic interstitial pneumonia, AIDS and Langerhans cell histiocytosis but not with sarcoidosis.
Marzouk
Kamel
K
Division of Pulmonary and Critical Care Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. marzouk@usc.edu
Corate
Lalaine
L
Saleh
Samer
S
Sharma
Om P
OP
D000328:Adult; D002454:Cell Differentiation; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000175:diagnosis; D005260:Female; D004854:Herpesvirus 4, Human / Q000502:physiology; D006646:Histiocytosis, Langerhans-Cell / Q000276:immunology / Q000473:pathology; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000821:virology*; D011650:Pulmonary Alveoli / Q000821:virology; D013906:Thoracoscopy; D014763:Viral Matrix Proteins / Q000378:metabolism; D014779:Virus Replication
C037662:EBV-associated membrane antigen, Epstein-Barr virus; D014763:Viral Matrix Proteins