Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Chronic Epstein-Barr virus infection causing both benign and malignant lymphoproliferative disorders

  • Kwun, Yoojin (Department of Pediatrics, Asan Medical Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Hong, Soo-Jong (Department of Pediatrics, Asan Medical Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Lee, Jin Seong (Department of Radiology, Asan Medical Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Son, Da Hye (Department of Pathology, Asan Medical Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Seo, Jong Jin (Department of Pediatrics, Asan Medical Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine)
  • Received : 2013.08.30
  • Accepted : 2013.10.16
  • Published : 2014.09.10
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Abstract

The Epstein-Barr virus (EBV) is oncogenic and can transform B cells from a benign to a malignant phenotype. EBV infection is also associated with lymphoid interstitial pneumonia (LIP). Here, we report the case of a 14-year-old boy who was diagnosed with a latent EBV infection and underlying LIP, without any associated immunodeficiency. He had been EBV-seropositive for 8 years. The first clinical presentations were chronic respiratory symptoms and recurrent pneumonia. The symptoms worsened in the following 2 years. The results of in situ hybridization were positive for EBV, which led to a diagnosis of LIP. The diagnosis was confirmed by the results of a thoracoscopic lung biopsy. The EBV titer of the bronchoalveolar lavage specimens obtained after acyclovir treatment was found to be fluctuating. The patient had latent EBV infection for 8 years, until presented at the hospital with intermittent abdominal pain and distension. Physical examination and pelvic computed tomography revealed a large mesenteric mass. A biopsy of the excised mass led to a diagnosis of Burkitt's lymphoma (BL). The patient received combination chemotherapy for 4 months, consisting of vincristine, methotrexate, cyclophosphamide, doxorubicin, and prednisolone. He is now tumor-free, with the LIP under control, and is being followed-up at the outpatient clinic. This is the first report of a Korean case of chronic latent EBV infection that developed into LIP and BL in a nonimmunocompromised child.

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References

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