Krupka Joanna Alicja, Samelska Katarzyna, Tomasik Anna, Stelmaszczyk-Emmel Anna, Pawelec Katarzyna
Student's Scientific Group 'SPHEROCYTE' Department of Paediatric Haematology and Oncology, Warsaw Medical University, Poland.
Department of Paediatric Haematology and Oncology, Warsaw, Medical University, Poland.
Cent Eur J Immunol. 2017;42(2):210-212. doi: 10.5114/ceji.2017.69364. Epub 2017 Aug 8.
Primary Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infection usually affects preadolescent children or young adults, causing similar clinical presentation. Signs and symptoms are typically mild, and the majority of clinical and laboratory findings resolve spontaneously within one month after onset. In adulthood, the risk of fulminant EBV infection and severe complications is much higher, which may be related to increasing memory CD8+ T-cell population with age. It is still not clear what exactly triggers T-cell clonal proliferation. Animals model studies on heterologous immunity between viruses revealed that pre-existing memory T-cells may contribute to excessive immune response during subsequent infection with a new, unrelated pathogen. A 3.5-year-old girl was admitted to hospital with a suspicion of lymphoproliferative disorder. Peripheral blood smear revealed a massive lymphocytosis (61,600 cells/µl) with 62% share of atypical lymphocytes. The clinical presentation and positive EBV and CMV IgM test strongly suggested infectious mononucleosis syndrome as a result of EBV and CMV coinfection.
原发性爱泼斯坦-巴尔病毒（EBV）和巨细胞病毒（CMV）感染通常影响青春期前儿童或年轻人，导致相似的临床表现。体征和症状通常较轻，大多数临床和实验室检查结果在发病后一个月内可自行缓解。在成年人中，暴发性EBV感染和严重并发症的风险要高得多，这可能与随着年龄增长记忆性CD8+T细胞数量增加有关。目前仍不清楚究竟是什么触发了T细胞克隆增殖。关于病毒间异源免疫的动物模型研究表明，预先存在的记忆性T细胞可能导致在随后感染新的无关病原体期间出现过度免疫反应。一名3.5岁女孩因疑似淋巴增殖性疾病入院。外周血涂片显示大量淋巴细胞增多（61,600个细胞/微升），其中非典型淋巴细胞占62%。临床表现以及EBV和CMV IgM检测呈阳性强烈提示该患儿因EBV和CMV合并感染导致传染性单核细胞增多症综合征。
