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The frequency of epstein-barr virus infection and associated lymphoproliferative syndrome after transplantation and its manifestations in children

Ho, M and Jaffe, R and Miller, G and Breinig, MK and Stephen Dummer, J and Makowka, L and Wayne Atchison, R and Karrer, F and Nalesnik, MA and Starzl, TE (1988) The frequency of epstein-barr virus infection and associated lymphoproliferative syndrome after transplantation and its manifestations in children. Transplantation, 45 (4). 719 - 727. ISSN 0041-1337

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Abstract

Twenty cases of Epstein-Barr virus (EBV)-associated lymphoproliferative syndrome (LPS), defined by the presence of EBV nuclear antigen and/or EBV DNA in tissues, were diagnosed in 1467 transplant recipients in Pittsburgh from 1981—1985. The frequency of occurrence in pediatric transplant recipients was 4% (10/ 253), while in adults it was 0.8% (10/1214) (P < .0005). The frequency of LPS in adults declined after 1983 coincidental with the introduction of cyclosporine monitoring. However there was no apparent decline of LPS in children. We describe these ten pediatric cases and one additional case of LPS in a child who received her transplant before 1981. The frequency of EBV infection in 92 pediatric liver recipients was 63%. Of these subjects, 49% were sero-negative and 77% of those acquired primary infection. Of 11 cases of pediatric EBV-associated LPS, 10 were in children who had primary infection shortly before or after transplantation. These results reinforce the impor-tance of primary EBV infection in producing LPS, which was previously shown in adults. Children are at greater risk because they are more likely to be seronegative for EBV and to acquire primary infection. Three clinical types of LPS were recognized in children. The first (5 cases) was a self-limited mononucleo-sislike syndrome. The second syndrome (4 cases) began similarly, but then progressed over the next two months to widespread lymphoproliferation in internal organs and death. The third type (2 cases) was an extranodal intestinal monoclonal B cell lymphoma, occurring late after primary infection. © 1988 by The Williams and Wilkins Co.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Ho, Mmonto@pitt.eduMONTO
Jaffe, R
Miller, G
Breinig, MK
Stephen Dummer, J
Makowka, L
Wayne Atchison, R
Karrer, F
Nalesnik, MA
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1988
Date Type: Publication
Journal or Publication Title: Transplantation
Volume: 45
Number: 4
Page Range: 719 - 727
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1337
Other ID: uls-drl:31735062129634, Starzl CV No. 811
Date Deposited: 08 Apr 2010 17:13
Last Modified: 12 Oct 2017 09:55
URI: http://d-scholarship.pitt.edu/id/eprint/4197

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