title: Epstein-Barr virus in the enlarged salivary tissues of patients with IgG4-related disease.
abstract: OBJECTIVE
  Immunoglobulin G4-related disease (IgG4-RD) is a recently recognized disease entity characterized by high-serum IgG4 concentration and IgG4-producing plasma cell production with fibrotic or sclerotic changes in affected organs. We aimed to clarify the roles of Epstein-Barr virus (EBV) in patients with IgG4-RDs.
  
  
  METHODS
  A retrospective clinical study at the Yamagata University School of Medicine, Yamagata, Japan.
  
  
  METHODS
  The patient group consisted of four males and four females with an average age of 62 years (range: 48-73). Expression of IgG4, latent member protein 1, EBV nuclear antigens-2, and EBV-encoded RNA in affected salivary glands from patients with IgG4-RD was examined by using immunohistochemistry and in situ hybridization. The copy number of EBV DNA in the salivary glands was also investigated by real-time polymerase chain reaction.
  
  
  RESULTS
  All patients had hard masses in the salivary or lacrimal glands, or both, bilaterally. Serum concentrations of IgG4 were elevated in all cases (mean 589.1, range 129-1750), and IgG4-positive plasmacytes were observed in the involved salivary glands. Four patients developed potentially life-threatening systemic involvement after initial salivary gland swelling. EBV-associated molecules (EBNA and EBER) were overexpressed in the affected salivary glands. The copy number of EBV DNA was significantly higher in patients with potentially life-threatening systemic involvement than in patients without systemic involvement (P < 0.05).
  
  
  CONCLUSIONS
  These results suggest that the copy number of EBV DNA could be useful as diagnostic findings in IgG4-RD to predict potentially life-threatening systemic involvement.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Yamagata city hospital Saiseikan, Japan.|Department of Infectious Diseases, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Furukawa
authors.affiliation: Department of Infectious Diseases, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Shimotai
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Yamagata city hospital Saiseikan, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Ohta
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Yamagata city hospital Saiseikan, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ishida
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Yamagata city hospital Saiseikan, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kurakami
authors.affiliation: Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Yamakawa
authors.affiliation: Department of Infectious Diseases, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Hongo
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Yamagata city hospital Saiseikan, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Kakehata
mesh_terms: D000368:Aged; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D001327:Autoimmune Diseases / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis*; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D012466:Salivary Gland Diseases / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D012469:Salivary Glands / Q000276:immunology / Q000821:virology*
chemical_list: D000888:Antibodies, Anti-Idiotypic; D007074:Immunoglobulin G; D012367:RNA, Viral
keywords: EBER; EBNA; Epstein-Barr virus; IgG4-related disease