title: Production of thyrotropin receptor antibodies in acute phase of infectious mononucleosis due to Epstein-Barr virus primary infection: a case report of a child.
abstract: Various autoantibodies have been reported to be detected during the progression of infectious mononucleosis. We observed a case of infectious mononucleosis due to Epstein-Barr virus primary infection for 2 months, and noticed the transiently increased titer of thyrotropin receptor autoantibodies detected at the acute phase on the 3rd day after admission. At that time, real-time quantitative PCR also revealed the mRNA expressions of an immediate early lytic gene, BZLF1, and a latent gene, EBNA2. The expression of BZLF1 mRNA means that Epstein-Barr virus infects lytically, and EBNA2 protein has an important role in antibody production as well as the establishment of Epstein-Barr virus latency. These results suggest that Epstein-Barr virus lytic infection is relevant to thyrotropin receptor autoantibody production. Thyrotropin receptor autoantibodies stimulate thyroid follicular cells to produce excessive thyroid hormones and cause Graves' disease. Recently, we reported the thyrotropin receptor autoantibody production from thyrotropin receptor autoantibody-predisposed Epstein-Barr virus-infected B cells by the induction of Epstein-Barr virus lytic infection in vitro. This case showed in vivo findings consistent with our previous reports, and is important to consider the pathophysiology of Graves' disease and one of the mechanisms of autoimmunity.
authors: Division of Molecular Pathology, Department of Pathology, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503 Japan.
authors: Keiko
authors: K
authors: Nagata
authors: Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori 683-8504 Japan.
authors: Keisuke
authors: K
authors: Okuno
authors: Division of Molecular Pathology, Department of Pathology, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503 Japan.
authors: Marika
authors: M
authors: Ochi
authors: Division of Molecular Pathology, Department of Pathology, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503 Japan.
authors: Keisuke
authors: K
authors: Kumata
authors: Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori 683-8504 Japan.
authors: Hitoshi
authors: H
authors: Sano
authors: Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori 683-8504 Japan.
authors: Naohiro
authors: N
authors: Yoneda
authors: Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori 683-8504 Japan.
authors: Jun-Ichi
authors: J
authors: Ueyama
authors: Division of Molecular Pathology, Department of Pathology, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503 Japan.
authors: Michiko
authors: M
authors: Matsushita
authors: Division of Molecular Pathology, Department of Pathology, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503 Japan.
authors: Satoshi
authors: S
authors: Kuwamoto
authors: Division of Molecular Pathology, Department of Pathology, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503 Japan.
authors: Masako
authors: M
authors: Kato
authors: Division of Molecular Pathology, Department of Pathology, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503 Japan.
authors: Ichiro
authors: I
authors: Murakami
authors: Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori 683-8504 Japan.
authors: Susumu
authors: S
authors: Kanzaki
authors: Division of Molecular Pathology, Department of Pathology, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503 Japan.
authors: Kazuhiko
authors: K
authors: Hayashi
keywords: Autoantibody; Epstein–Barr virus (EBV); Graves’ disease; Infectious mononucleosis; Lytic infection; Reactivation; Thyrotropin receptor antibody (TRAb)