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Persistent epstein-barr virus infection mimicking juvenile chronic
myelogenous leukemia: immunologic and hematologic studies
HG Herrod, LW Dow and JL Sullivan
Epstein-Barr virus (EBV) infections may induce a diverse clinical picture,
ranging from the well characterized infectious mononucleosis (IM) syndrome
to the rare X-linked lymphoproliferative syndrome. We describe two
unrelated children, a 21-mo-old white boy and a 15-mo-old black girl, who
presented with the clinical and laboratory findings characteristically seen
in juvenile chronic myelogenous leukemia (JCML). Results of periodic
serodiagnostic tests indicated that they likely have persistent infection
with EBV. Both had elevated IgG antibody to viral capsid antigen (greater
than or equal to 1:320) and antibody to early antigen (1:20-1:40) that have
persisted for 3 yr of more. Both patients had EBV-specific suppressor cell
activity, decreased natural killer cell activity, and diminished antibody-
dependent cell-mediated cytotoxicity (ADCC) activity. These changes suggest
an underlying defect in the immunoregulatory network controlling EBV
infection. The patients have shown clinical improvement without treatment.
It appears that EBV infections are capable of inducing symptoms similar to
those seen in JCML. Careful evaluation for evidence of EBV infection in
patients presenting with symptoms compatible with JCML seems warranted.
Volume 61,
Issue 6,
pp. 1098-1104,
06/01/1983
Copyright © 1983 by The American Society of Hematology
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