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Metwally SA, Abo-Shadi MA, Abdel Fattah NF, Barakat AB, Rabee OA, Osman AM, Helal AM, Hashem T, Moneer MM, Chehadeh W, Loutfy SA. Presence of HPV, EBV and HMTV Viruses Among Egyptian Breast Cancer Women: Molecular Detection and Clinical Relevance. Infect Drug Resist 2021; 14:2327-2339. [PMID: 34188499 PMCID: PMC8236253 DOI: 10.2147/idr.s313219] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/07/2021] [Indexed: 12/20/2022] Open
Abstract
Background Oncogenic viruses, their possible association with breast cancer (BC) and effect on its clinical course are interesting issue. The present study evaluates the presence of human papillomavirus (HPV), EpsteinBarr virus (EBV), and human mammary tumor virus (HMTV) in BC and their relation with clinico-pathological characteristics. Patients and Methods This study was conducted on 80 Egyptian women with BC and 30 control women without known oncological disease. Forty formalin-fixed paraffin-embedded (FFPE) tissues, forty fresh tissue samples, and white blood cells (WBCs) of BC patients and WBCs of controls were subjected to a qualitative polymerase chain reaction (PCR). Quantitative real-time PCR was used to measure viral loads in fresh tissues of BC. The result was correlated with clinico-pathological characteristics of BC. Results HPV was detected in 33 (41.25%), EBV in 30 (37.5%) and HMTV in 33 (41.25%) BC patients. None of the control women was positive for HPV or EBV while HMTV was detected in 7 (23.3%). Among 40 BC WBCs specimens, HPV/HMTV were found together in 25%, followed by EBV/HMTV in 2.5% and EBV/HPV in 2.5%. However, the three viruses (HPV/EBV/HMTV) were found together in only 5%. In the 40 fresh BC tissues, the three viruses were found together in 12 (30%), EBV/HMTV in 7 (17.5%), HPV/HMTV in 4 (10%), and HPV/EBV in 4 (10%). EBV, HMTV, or multiple viral infections were associated with younger age of BC women. HPV, EBV, and HMTV median loads in fresh tissues were 4.8×103 copies/μL, 6.3×103 copies/μL, and 97 copies/μL, respectively. Conclusion WBCs could be a more suitable specimen instead of fresh tissue for HMTV detection in BC patients to avoid invasive procedures. The presence of HPV, EBV, and HMTV together in Egyptian women with BC was significantly associated with younger age.
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Affiliation(s)
- Shimaa A Metwally
- Microbiology & Immunology Department, Faculty of Pharmacy for Girls, Al-Azhar University, Cairo, Egypt
| | - Maha A Abo-Shadi
- Microbiology & Immunology Department, Faculty of Pharmacy for Girls, Al-Azhar University, Cairo, Egypt
| | - Nasra F Abdel Fattah
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
| | - Ahmed B Barakat
- Microbiology Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Omar A Rabee
- Microbiology Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Ahmed M Osman
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
| | - Amany M Helal
- Medical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Tarek Hashem
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Manar M Moneer
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Wassim Chehadeh
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Samah A Loutfy
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute (NCI), Cairo University, Cairo, Egypt.,Nanotechnology Research Center, British University in Egypt (BUE), Cairo, Egypt
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Zheng Q, Zhu K, Gao CN, Xu YP, Lu MP. Prevalence of Epstein-Barr virus infection and characteristics of lymphocyte subsets in newly onset juvenile dermatomyositis. World J Pediatr 2021; 17:205-209. [PMID: 31549298 DOI: 10.1007/s12519-019-00314-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/02/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND The underlying etiology of juvenile dermatomyositis (JDM) is unknown. T cell deficiency as well as Epstein-Barr virus (EBV) infection had been suspected to be involved in the pathogenesis, but it has been poorly evaluated in JDM patients. METHODS This study described the traits of T and B lymphocyte subsets in newly onset JDM patients and the incidence of EBV infection in JDM patients compared with match controls. Newly developed JDM patients from 2014 to 2018 were included in the study. Lymphocytes with different markers (CD3+, CD3+CD4+, CD3+CD8+, CD3-CD19+ and CD3-CD16+CD56+) were tested with flow cytometry in the first admission or after 6 months of treatment. Statistical analysis was conducted to compare the EBV infection in the group of JDM patients and controls. RESULTS We observed that JDM patients had higher positive rate of Epstein-Barr nuclear antigen-immunoglobulin G (IgG) (P < 0.0001) as well as EBV capsid antigen-IgG (P < 0.05) than normal controls. CD3-CD16+CD56+ lymphocyte was found to be extremely low in early stage of JDM patients, but increased after 6 months of treatment (P = 0.0091). CONCLUSIONS The level of CD3-CD16+CD56+ cells may associate with the clinical course of JDM. EBV may act as an environmental factor predisposing patients to the development of JDM.
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Affiliation(s)
- Qi Zheng
- Department of Rheumatology, Immunology and Allergy, Children's Hospital, Zhejiang University School of Medicine, 57# Zhu Gan Road, Hangzhou, 310000, China
| | - Kun Zhu
- Department of Pathology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cai-Na Gao
- Department of Rheumatology, Immunology and Allergy, Children's Hospital, Zhejiang University School of Medicine, 57# Zhu Gan Road, Hangzhou, 310000, China
| | - Yi-Ping Xu
- Department of Rheumatology, Immunology and Allergy, Children's Hospital, Zhejiang University School of Medicine, 57# Zhu Gan Road, Hangzhou, 310000, China
| | - Mei-Ping Lu
- Department of Rheumatology, Immunology and Allergy, Children's Hospital, Zhejiang University School of Medicine, 57# Zhu Gan Road, Hangzhou, 310000, China.
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3
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Loutfy SA, Abo-Shadi MA, Fawzy M, El-Wakil M, Metwally SA, Moneer MM, Fattah NFA, Kassem S, Elgebaly A. Epstein-Barr virus and cytomegalovirus infections and their clinical relevance in Egyptian leukemic pediatric patients. Virol J 2017; 14:46. [PMID: 28264674 PMCID: PMC5339968 DOI: 10.1186/s12985-017-0715-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/23/2017] [Indexed: 12/15/2022] Open
Abstract
Background Epstein-Barr virus (EBV) and human cytomegalovirus (CMV) infections are environmental risk factors affecting the outcome of cancer due to an impairment in the cell-mediated immunity. Therefore, this study aimed to detect the frequency of EBV and CMV DNA and their association with clinical characteristics and outcome of pediatric leukemic patients. Methods Samples of 50 immunocompromised pediatric leukemic patients and 30 apparently healthy children were subjected to the amplification of EBV DNA by one version of PCR targeting the Bam H1 W region of the genomic region of EBV, and the amplification of CMV DNA by targeting the CMV UL97 genomic region by a second round PCR. All investigations were performed on WBCs and sera. Results were correlated with the clinical and laboratory characteristics of the disease, and with overall survival. Results EBV and CMV DNA were detected in 20 and 54% of leukemic patients, respectively. Nine out of ten patients with EBV DNA (90%) were positive for CMV DNA in their sera. The presence of EBV DNA or CMV DNA was associated with neutropenia and a low total leukocyte count (TLC) (p = 0.02, 0.03, respectively). The presence of severe CMV disease, longer duration of febrile neutropenia, neutropenia, lymphopenia, thrombocytopenia and the presence of EBV DNA in patients’ sera were significantly associated with worse overall survival. Conclusion The detection of CMV disease and EBV DNA is relatively common in leukemic children and is significantly associated with a decline in the overall survival.
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Affiliation(s)
- Samah Aly Loutfy
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Fom El-Khalig, Cairo, 11796, Egypt.
| | - Maha A Abo-Shadi
- Microbiology and Immunology Department, Faculty of Pharmacy (Girls), Al Azhar University, Nasr City, Egypt
| | - Mohamed Fawzy
- Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mohamed El-Wakil
- Clinical Oncology Department, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Shimaa A Metwally
- Microbiology and Immunology Department, Faculty of Pharmacy (Girls), Al Azhar University, Nasr City, Egypt
| | - Manar M Moneer
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Nasra F Abdel Fattah
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Fom El-Khalig, Cairo, 11796, Egypt
| | - Sara Kassem
- Chemistry of natural and microbial products Department Pharmaceutical Industries Division, National Research Center, Giza, Egypt
| | - Ahmed Elgebaly
- Faculty of Medicine, Al Azhar University, Nasr City, Egypt.,Medical Research Group of Egypt, Cairo, Egypt
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4
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Zekri ARN, Bahnassy AA, Mohamed WS, El-Kassem FA, El-Khalidi SJ, Hafez MM, Hassan ZK. Epstein-Barr virus and breast cancer: epidemiological and molecular study on Egyptian and Iraqi women. J Egypt Natl Canc Inst 2012; 24:123-31. [PMID: 22929918 DOI: 10.1016/j.jnci.2012.06.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 05/30/2012] [Accepted: 06/03/2012] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND PURPOSE The role of Epstein-Barr virus (EBV) in breast carcinogenesis is still controversial. Unraveling this relationship is potentially important for better understanding of breast cancer etiology, early detection and possibly prevention of breast cancer. The aim of the current study is to unravel the association between EBV and primary invasive breast cancer (PIBC) in two different Arab populations (Egyptian and Iraqi women). PATIENTS AND METHODS The study was done on paraffin-embedded tissues of 40 Egyptian and 50 Iraqi patients with PIBC in addition to 20 normal breast tissues as controls for each group. Both controls and neoplastic tissues were assessed for the expression of EBV genes and proteins (EBNA-1, LMP-1, and EBER) as well as CD21 marker by immunohistochemistry (IHC), in situ hybridization (ISH) and PCR techniques. RESULTS Our gold standard for EBV reactivity in breast cancer cases was positivity of both EBNA1 by PCR and EBER by in situ hybridization. EBV was detected in 18/40 (45%) and 14/50 (28%) of Egyptian and Iraqi women; respectively where p=0.073, compared to 0/20 (0%) of their control groups (p<0.05). Regarding the association between EBV positivity and tumor grade, there was not any statistical significant difference between EBV presence and tumor grade in both populations where p=0.860 and p=0.976 and the calculated rank biserial correlation coefficient was 0.114 and 0.269 for Egyptian and Iraqi women respectively. CONCLUSION Our findings show that EBV might act as a promoter for the development of PIBC and it might contribute to increased tumor aggressiveness in Egyptian and Iraqi patients.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/epidemiology
- Breast Neoplasms/metabolism
- Breast Neoplasms/virology
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/virology
- Carcinoma, Lobular/epidemiology
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/virology
- Egypt/epidemiology
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/epidemiology
- Epstein-Barr Virus Infections/metabolism
- Female
- Gene Expression
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/metabolism
- Humans
- Iraq/epidemiology
- Middle Aged
- Molecular Epidemiology
- Receptors, Complement 3d/metabolism
- Viral Proteins/genetics
- Viral Proteins/metabolism
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Affiliation(s)
- Abdel-Rahman N Zekri
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo 11976, Egypt.
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5
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Polymyositis/dermatomyositis and nasopharyngeal carcinoma: The Epstein–Barr virus connection? J Clin Virol 2010; 49:290-5. [DOI: 10.1016/j.jcv.2010.08.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 07/12/2010] [Accepted: 08/28/2010] [Indexed: 11/19/2022]
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6
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Liu QF, Fan ZP, Luo XD, Sun J, Zhang Y, Ding YQ. Epstein-Barr virus-associated pneumonia in patients with post-transplant lymphoproliferative disease after hematopoietic stem cell transplantation. Transpl Infect Dis 2010; 12:284-91. [DOI: 10.1111/j.1399-3062.2010.00502.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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7
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Chen YJ, Wu CY, Huang YL, Wang CB, Shen JL, Chang YT. Cancer risks of dermatomyositis and polymyositis: a nationwide cohort study in Taiwan. Arthritis Res Ther 2010; 12:R70. [PMID: 20398365 PMCID: PMC2888225 DOI: 10.1186/ar2987] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2009] [Revised: 02/19/2010] [Accepted: 04/16/2010] [Indexed: 12/27/2022] Open
Abstract
Introduction The association of idiopathic inflammatory myositis (IIM) and malignancies has been reported, but rarely in Asian countries. Our aim was to investigate the risk of cancer among IIM patients without a prior history of malignancies, in Taiwan. Methods We conducted a nationwide cohort study of 1,012 patients with dermatomyositis (DM) and 643 patients with polymyositis (PM), but without prior history of malignancies, utilizing the National Health Insurance Database from 1997 to 2007. Standardized incidence ratios (SIRs) of cancers were analyzed. Results A total of 95 cancers (9.4%) in DM and 33 cancers (4.4%) in PM were identified. Overall cancer risk was significantly elevated in DM patients (SIR = 5.11, 95% confidence interval [CI] = 5.01 to 5.22) and PM patients (SIR = 2.15, 95% CI = 2.08 to 2.22). Most cancers were detected in the first year of observation. The risk of cancer decreased with observation time, yet remained elevated compared with the general population in both study groups after 5 years of follow-up. DM was associated with sustained elevated risk of cancers in every age group, whereas the risk of cancer in PM was highest in younger patients and decreased with age. DM patients were at the greatest risk of cancers of the nasopharynx, lungs and hematopoietic malignancies. Conclusions Patients with IIM are at increased risk for cancer and should receive age-appropriate and gender-appropriate malignancy evaluations, with additional assessment for nasopharyngeal, lung and hematologic malignancy following diagnosis, and with continued vigilance for development of cancers in follow-up.
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Affiliation(s)
- Yi-Ju Chen
- Department of Dermatology, National Yang-Ming University, No, 155, Sec, 2, Linong Street, Taipei 112, Taiwan
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Takada K, Nagasaka K, Miyasaka N. Polymyositis/dermatomyositis and interstitial lung disease: A new therapeutic approach with T-cell-specific immunosuppressants. Autoimmunity 2009; 38:383-92. [PMID: 16227154 DOI: 10.1080/08916930500124023] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Interstitial lung disease (ILD) is a common complication of polymyositis (PM) and dermatomyositis (DM), and accounts for a significant proportion of their morbidity and mortality because of the resistance to therapeutic agents including corticosteroids. Its pathogenic mechanism is not known, but several studies have provided findings implicating that T-cells, especially activated CD8+ cells, may play essential roles, and thus could be therapeutic targets in this disease. To test this hypothesis, we began clinical investigation of the efficacy of T-cell-specific immunosuppressants, cyclosporine (CsA) and FK506, in PM/DM patients with ILD. In our retrospective nationwide multi-center study compiling a total of 53 patients, a combination of CsA and corticosteroids resulted in favorable early and long-term outcome in the majority of patients except for DM patients with acute ILD. In this subset, those who received the combination as an initial therapy had better survival than those who initially received corticosteroids alone. FK506 has a similar mode of action but is up to 100-fold more potent than CsA in vitro, and has been used in more refractory ILD cases. We next reviewed 5 PM/DM patients with ILD who failed on various immunosuppressants including CsA and were subsequently treated with FK506 in our hospital, and found that 3 improved promptly, 1 gradually and steadily, and another case responded slowly after prednisolone dose was increased. None developed adverse effects. In summary, these T-cell targeted therapies have a potential to be the cornerstone of the treatment for ILD in PM/DM patients. The combination therapy with CsA and corticosteroids may be efficacious especially when used early. FK506 may be advantageous even in refractory cases to CsA. These findings indicate that further investigation is warranted. Currently, prospective investigation of FK506 is underway.
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Affiliation(s)
- Kazuki Takada
- Department of Medicine and Rheumatology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8519, Japan.
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9
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Huang YL, Chen YJ, Lin MW, Wu CY, Liu PC, Chen TJ, Chen YC, Jih JS, Chen CC, Lee DD, Chang YT, Wang WJ, Liu HN. Malignancies associated with dermatomyositis and polymyositis in Taiwan: a nationwide population-based study. Br J Dermatol 2009; 161:854-60. [PMID: 19558555 DOI: 10.1111/j.1365-2133.2009.09274.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous studies showed that idiopathic inflammatory myopathies (IIM) carried an increased risk of cancers. However, no large-scale study of IIM has been conducted in the Chinese population. OBJECTIVES We sought to delineate the association of IIM and various cancer types from a nationwide database in Taiwan. METHODS We analysed the published national data from records of National Health Insurance claims. Cases of dermatomyositis (DM) and polymyositis (PM) from 2000 to 2005 and cancers registered in the catastrophic illness profile from 1997 to 2006 were collected. A nationally representative cohort of 1,000,000 enrollees was included for comparison. RESULTS In total, 136 patients (12.8%) among 1059 cases of DM and 46 persons (7.0%) among 661 cases of PM carried internal malignancies. Patients with DM tended to have cancers of nasopharynx, lung and breast. On the other hand, patients with PM tended to have breast, uterine cervix and lung cancers. Compared with the general population, DM gave a 10-fold increased risk for cancers, in which a 66-fold increased risk for nasopharyngeal carcinoma and a 31-fold increased risk for lung cancer were the two most significant. For patients with PM, a 6-fold increased risk for cancer was observed. Juvenile DM had a 16-fold increased risk for haematopoietic or lymphoid malignancy. Two thirds of comorbid malignancies were detected shortly after the diagnoses of IIM, within a mean of 1-2 years. Overall, younger patients with IIM carried the highest risk for malignancies, especially those in their twenties and thirties. CONCLUSIONS This is the first large-scale study to report the associated malignancies and the cancer risk of IIM in Taiwan.
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Affiliation(s)
- Y L Huang
- Department of Dermatology, National Yang-Mind University, Taipei, Taiwan
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10
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Kaşifoğlu T, Korkmaz C, Ozkan R. Cytomegalovirus-induced interstitial pneumonitis in a patient with dermatomyositis. Clin Rheumatol 2005; 25:731-3. [PMID: 16267608 DOI: 10.1007/s10067-005-0062-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2005] [Accepted: 04/05/2005] [Indexed: 11/24/2022]
Abstract
Dermatomyositis (DM) patients might present with pulmonary involvement as the first manifestation or during the follow-up period. It is sometimes difficult to determine whether the clinical manifestations related with pulmonary involvement are due to DM or to an infectious process. We report a case of DM patient who developed interstitial pneumonitis induced by cytomegalovirus (CMV) while receiving immunosuppressive treatment. To the best of our knowledge, this is the second report in the literature of interstitial pneumonitis secondary to CMV infection in a patient with DM.
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Affiliation(s)
- Timuçin Kaşifoğlu
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
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11
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Uchiyama T, Arai K, Yamamoto-Tabata T, Hirai K, Kishimoto K, Nakamura Y, Hattori T. Generalized myositis mimicking polymyositis associated with chronic active Epstein-Barr virus infection. J Neurol 2005; 252:519-25. [PMID: 15742118 DOI: 10.1007/s00415-005-0679-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2004] [Revised: 09/22/2004] [Accepted: 10/04/2004] [Indexed: 11/27/2022]
Abstract
BACKGROUND Chronic generalized myositis has not so far been reported as a complication of chronic active Epstein-Barr virus infection (CAEBV). We encountered three patients with chronic generalized myositis mimicking polymyositis associated with CAEBV. METHODS To clarify the pathological character of this myositis, we investigated the distribution, clonality, and the immunophenotype of EBV-infected cells and lymphocytes infiltrating in muscles. RESULTS Clinically, two patients showed symmetrical proximal weakness and muscle atrophy as the initial and main symptom. Although the condition resembled polymyositis, they had also lingual and/or orbital myositis. The other patient showed generalized myositis at the late phase of CAEBV. In all of them, immunotherapy was ineffective and prognosis was poor. Intramuscular infiltrating lymphocytes in our patients were mainly CD45RO+, CD3+, CD4-, CD8-, TCR betaF1-, TCR deltaTCS1-, CD56-, CD79a-, CD21-, HLA-DR+, ZEBRA -, LMP1-, and EBER+ T cells. Oligoclonal expansion of EBV-infected T cells was shown in the muscles. However, there were no malignant lymphocytes. CONCLUSIONS This new form of myositis must be distinguished from polymyositis and the other conventional forms of myositis. Careful investigation of hidden CAEBV is recommended when patients present with steroid non-responsive chronic progressive generalized myositis, in particular, with lingual or orbital involvement.
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Affiliation(s)
- Tomoyuki Uchiyama
- Dept. of Neurology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
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12
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Marie I, Dominique S, Rémy-Jardin M, Hatron PY, Hachulla E. [Interstitial lung diseases in polymyositis and dermatomyositis]. Rev Med Interne 2001; 22:1083-96. [PMID: 11817120 DOI: 10.1016/s0248-8663(01)00473-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE Interstitial lung disease is one of the most common respiratory manifestations in polymyositis and dermatomyositis. It still remains a severe complication of the disease, leading to death related to ventilatory insufficiency in 30-66% of patients. CURRENT KNOWLEDGE AND KEY POINTS Time onset of interstitial lung disease is variable, although interstitial lung disease onset precedes initial manifestations of polymyositis/dermatomyositis in roughly half of the patients. Moreover, clinical presentation of interstitial lung disease can be dichotomized, according to patients' pulmonary manifestations, into: 1) both acute and aggressive lung disease similar to Hamman-Rich syndrome; 2) slowly progressive lung disease; and 3) an asymptomatic pattern. The methods of choice adopted for early diagnosis of interstitial lung disease are high-resolution computed tomography scan and pulmonary function tests, which should be performed during both initial evaluation of polymyositis/dermatomyositis and follow-up. Because anti-JO1 antibody is considered to be a marker of interstitial lung disease in polymyositis/dermatomyositis, close pulmonary follow-up of anti-JO1-positive patients with polymyositis is therefore required for early detection of subclinical impairment. Furthermore, histological lung findings provide prognostic data; patients with bronchiolitis obliterans organizing pneumonia (BOOP) indeed appear to have a more favorable outcome than those with usual interstitial pneumonia or diffuse alveolar damage. Finally, as a guide to both the severity and progress of interstitial lung disease, the significance of other investigations, notably bronchoalveolar lavage, remains controversial. FUTURE PROSPECTS AND PROJECTS Specific therapy of interstitial lung disease has not yet been clearly established in polymyositis/dermatomyositis patients. Corticosteroid therapy is considered the first line of therapy for polymyositis/dermatomyositis patients with interstitial lung disease. The association of cyclophosphamide and corticosteroids may be the most effective in patients with steroid-resistant interstitial lung disease. Early diagnosis and management of this disease is therefore of the utmost importance.
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Affiliation(s)
- I Marie
- Département de médecine interne, hôpital de Boisguillaume, CHU de Rouen, 76031 Rouen, France
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13
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Moudgil A, Nast CC, Bagga A, Wei L, Nurmamet A, Cohen AH, Jordan SC, Toyoda M. Association of parvovirus B19 infection with idiopathic collapsing glomerulopathy. Kidney Int 2001; 59:2126-33. [PMID: 11380814 DOI: 10.1046/j.1523-1755.2001.00727.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Collapsing glomerulopathy (CG), a disorder with severe glomerular and tubular involvement, occurs either as an idiopathic lesion or in some patients with human immunodeficiency virus (HIV) infection known as HIV-associated nephropathy (HIVAN). We previously reported a renal transplant recipient with de novo CG and red cell aplasia in association with persistent parvovirus B19 (PVB19) infection. This prompted us to look for an association between PVB19 infection and CG. METHODS DNA from archived biopsies of patients with CG was analyzed for PVB19 by polymerase chain reaction (PCR). Results were compared with HIVAN, idiopathic focal segmental glomerulosclerosis (FSGS), and controls. In situ hybridization (ISH) was done to localize PVB19 in renal biopsies. Peripheral blood specimens of patients with CG, HIV infection, healthy controls, and randomly selected hospitalized patients (sick controls) were also analyzed for PVB19. RESULTS PVB19 DNA was detected in renal biopsies of 18 out of 23 (78.3%) patients with CG, 3 out of 19 (15.8%) with HIVAN, 6 out of 27 (22.2%) with FSGS, and 7 out of 27 (25.9%) controls (P < 0.01, CG vs. HIVAN, FSGS, and controls). PVB19 was detected in peripheral blood of 7 out of 8 (87.5%) CG patients, 3 out of 22 (13.6%) with HIV infection, 4 out of 133 (3%) healthy controls, and 2 out of 50 (4%) sick controls (P < 0.001, CG vs. HIV infected, healthy, and sick controls). PVB19 was identified in glomerular parietal and visceral epithelial and tubular cells by ISH. CONCLUSIONS The significantly higher prevalence of PVB19 DNA in renal biopsies and peripheral blood of CG patients suggests a specific association between PVB19 infection and CG. In susceptible individuals, renal epithelial cell infection with PVB19 may induce CG.
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MESH Headings
- Biopsy
- DNA Primers
- DNA, Viral/analysis
- DNA, Viral/blood
- Glomerulosclerosis, Focal Segmental/epidemiology
- Glomerulosclerosis, Focal Segmental/pathology
- Glomerulosclerosis, Focal Segmental/virology
- HIV Infections/complications
- Humans
- Kidney/pathology
- Kidney/ultrastructure
- Kidney/virology
- Kidney Failure, Chronic/epidemiology
- Kidney Failure, Chronic/pathology
- Kidney Failure, Chronic/virology
- Microscopy, Electron
- Parvoviridae Infections/epidemiology
- Parvoviridae Infections/pathology
- Parvovirus B19, Human/genetics
- Parvovirus B19, Human/isolation & purification
- Prevalence
- Prospective Studies
- Red-Cell Aplasia, Pure/epidemiology
- Red-Cell Aplasia, Pure/pathology
- Red-Cell Aplasia, Pure/virology
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Affiliation(s)
- A Moudgil
- Department of Pediatrics, Division of Transplant Immunology, Steven Spielberg Pediatric Research Center, UCLA School of Medicine, Los Angeles, California, USA.
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14
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Al-Mayouf SM, Al-Eid W, Bahabri S, Al-Mofada S. Interstitial pneumonitis and air leakage in juvenile dermatomyositis. Rheumatology (Oxford) 2001; 40:588-90. [PMID: 11371672 DOI: 10.1093/rheumatology/40.5.588] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Tsukamoto K, Hayakawa H, Sato A, Chida K, Nakamura H, Miura K. Involvement of Epstein-Barr virus latent membrane protein 1 in disease progression in patients with idiopathic pulmonary fibrosis. Thorax 2000; 55:958-61. [PMID: 11050267 PMCID: PMC1745627 DOI: 10.1136/thorax.55.11.958] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The role of Epstein-Barr virus (EBV) in idiopathic pulmonary fibrosis (IPF) is uncertain. A study was undertaken to detect the virus in IPF as well as to clarify the influence of EBV on the clinical features of the disease. METHODS Twenty nine lung specimens were obtained from patients with IPF, as well as five specimens from patients with systemic sclerosis with pulmonary fibrosis (SSc) and 15 specimens from controls. EBV DNA and EBV latent membrane protein 1 (LMP1) were detected using the PCR method and immunohistochemical analysis, respectively. RESULTS EBV DNA was detected in 24 of 25 patients with IPF (96%), in all five patients with SSc (100%), and in 10 of 14 controls (71%). The detection ratio was significantly higher in patients with IPF than in controls (p = 0.047, odds ratio (OR) = 9.60, 95% confidence interval (CI) 0.9 to 96.9). Immunohistochemical analysis revealed that cuboidal epithelial cells were positively stained with anti-LMP1 antibody in nine of the 29 lung specimens from IPF patients. In contrast, neither the patients with SSc nor the control subjects showed positive staining. In the follow up periods LMP1 positive patients with IPF died more frequently from respiratory failure than LMP1 negative patients (4/9 versus 1/20; p = 0.022, OR = 15.20, 95% CI 1. 3 to 168.0). CONCLUSIONS EBV LMP1 positivity may be associated with more rapid disease progression in IPF.
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Affiliation(s)
- K Tsukamoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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16
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Abstract
Interstitial lung disease (ILD) is common in patients with polymyositis (PM) and dermatomyositis (DM), and is a major cause of morbidity. Although its cause is unknown, it is known to be closely associated with autoimmune disorders. Its manifestation has been found to be quite heterogeneous, as demonstrated by the differences among PM/DM patients in their immunologic profiles and histopathologic findings, which suggest variations in immunopathogenetic mechanisms. We review the clinicopathologic and immunologic findings in ILD associated with PM/DM, and discuss recent advances in classification, autoantibodies, and treatment. The most critical issues are to clarify the immunopathogenesis of severe forms of ILD, such as rapidly progressive ILD associated with amyopathic DM, and to establish the most appropriate therapy.
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Affiliation(s)
- M Hirakata
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
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17
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Abstract
Polymyositis is associated with a variety of pulmonary manifestations that may complicate an established case, occur simultaneously with the muscle manifestations, or precede the muscle disease. Included are respiratory muscle involvement, aspiration syndromes, and a variety of interstitial lung reactions.
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Affiliation(s)
- M I Schwarz
- Department of Medicine, University of Colorado Health Sciences Center, Denver, USA
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