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Cardiovascular Complications Associated with Chronic Active Epstein–Barr Virus Infection

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Abstract

This study aimed to assess the outcome of cardiovascular diseases for patients with chronic active Epstein–Barr virus infection (CAEBV). The study enrolled 15 patients (7 boys and 8 girls) who fulfilled the diagnostic criteria for CAEBV, including 10 patients with T-cell type and 3 patients with natural killer (NK)-cell type. The median age at the CAEBV onset was 6.3 years (range, 1.2–17.8 years). Regular cardiologic studies were performed during the median follow-up period of 8 years (range, 2–20 years). Nine patients (60%) had cardiac diseases including coronary artery lesion (CAL) (n = 4, 44%), decreased left ventricular ejection fraction and pericardial effusion in (n = 3, 33%), complete atrioventricular block (n = 1), and sudden arrest (n = 1). The frequency of fever (78%, p = 0.04) or cytopenias (100%, p = 0.01), as the major symptom among patients with cardiac complications, was higher than among those without complications. The median time from disease onset to detection of CAL was 3.4 years (range, 1.8–8.6 years). The mean z-score increased to 3.98. Seven patients (78%) with cardiac complications died of disease progression, hematopoietic stem cell transplantation–related events, or both. In two patients, CAL regressed after allogeneic cord blood transplantation. Among CAEBV patients, CAL was the most common cardiac complication and could not be controlled without the eradication of EBV-infected T- and NK-cells.

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Abbreviations

BMT:

Bone marrow transplantation

CAL:

Coronary artery lesion

CBT:

Cord blood transplantation

CAEBV:

Chronic active Epstein–Barr virus infection

HSCT:

Hematopoietic stem cell transplantation

LVEF:

Left ventricular ejection fraction

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Acknowledgments

This work was supported by a Grant-in-Aid for Scientific Research (C) to Shouichi Ohga and a grant by the Ministry of Education, Culture, Sports, Science and Technology of Japan to Jun Muneuchi. We thank Dr. Brian Thomas Quinn (Associate Professor, Department of Linguistic Environment, Faculty of Languages and Cultures, Kyushu University) for kindly correcting the manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Jun Muneuchi, Shouichi Ohga, Masataka Ishimura, Kazuyuki Ikeda, Kenichiro Yamaguchi, Akihiko Nomura, Hidetoshi Takada & Toshiro Hara

  2. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yasunobu Abe

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  1. Jun Muneuchi
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  2. Shouichi Ohga
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  3. Masataka Ishimura
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  4. Kazuyuki Ikeda
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  5. Kenichiro Yamaguchi
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Correspondence to Shouichi Ohga.

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Muneuchi, J., Ohga, S., Ishimura, M. et al. Cardiovascular Complications Associated with Chronic Active Epstein–Barr Virus Infection. Pediatr Cardiol 30, 274–281 (2009). https://doi.org/10.1007/s00246-008-9343-8

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  • DOI: https://doi.org/10.1007/s00246-008-9343-8

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