Bolis Vasileios, Karadedos Christos, Chiotis Ioannis, Chaliasos Nikolaos, Tsabouri Sophia
Child Health Department, University Hospital of Ioannina (UHI), Ioannina, Greece.
Child Health Department, University Hospital of Ioannina (UHI), Ioannina, Greece.
J Pediatr (Rio J). 2016 Mar-Apr;92(2):113-21. doi: 10.1016/j.jped.2015.06.007. Epub 2016 Jan 20.
Clarify the frequency and the pathophysiological mechanisms of the rare manifestations of Epstein-Barr virus infection.
Original research studies published in English between 1985 and 2015 were selected through a computer-assisted literature search (PubMed and Scopus). Computer searches used combinations of key words relating to "EBV infections" and "atypical manifestation."
Epstein-Barr virus is a herpes virus responsible for a lifelong latent infection in almost every adult. The primary infection concerns mostly children and presents with the clinical syndrome of infectious mononucleosis. However, Epstein-Barr virus infection may exhibit numerous rare, atypical and threatening manifestations. It may cause secondary infections and various complications of the respiratory, cardiovascular, genitourinary, gastrointestinal, and nervous systems. Epstein-Barr virus also plays a significant role in pathogenesis of autoimmune diseases, allergies, and neoplasms, with Burkitt lymphoma as the main representative of the latter. The mechanisms of these manifestations are still unresolved. Therefore, the main suggestions are direct viral invasion and chronic immune response due to the reactivation of the latent state of the virus, or even various DNA mutations.
Physicians should be cautious about uncommon presentations of the viral infection and consider EBV as a causative agent when they encounter similar clinical pictures.
阐明爱泼斯坦-巴尔病毒感染罕见表现的发生率及病理生理机制。
通过计算机辅助文献检索（PubMed和Scopus）选取1985年至2015年间发表的英文原创研究。计算机检索使用了与“EBV感染”和“非典型表现”相关的关键词组合。
爱泼斯坦-巴尔病毒是一种疱疹病毒，几乎在每个成年人中都会引发终身潜伏感染。原发性感染主要发生在儿童，表现为传染性单核细胞增多症的临床综合征。然而，爱泼斯坦-巴尔病毒感染可能表现出众多罕见、非典型且具有威胁性的表现。它可能导致继发性感染以及呼吸、心血管、泌尿生殖、胃肠和神经系统的各种并发症。爱泼斯坦-巴尔病毒在自身免疫性疾病、过敏和肿瘤的发病机制中也起着重要作用，其中伯基特淋巴瘤是后者的主要代表。这些表现的机制仍未明确。因此，主要推测是病毒直接侵袭以及由于病毒潜伏状态的重新激活导致的慢性免疫反应，甚至是各种DNA突变。
医生应对病毒感染的不常见表现保持谨慎，在遇到类似临床症状时应考虑将EBV作为病原体。
