Departments of Pediatrics.
Department of Pediatrics, School of Medicine, Shinshu University.
J Pediatr Hematol Oncol. 2020 Nov;42(8):e756-e758. doi: 10.1097/MPH.0000000000001647.
A 3-year-old boy was clinically diagnosed with Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis. We identified EBV-infected CD8-positive T-lymphocytes by cytologic double staining of the peripheral blood for EBV-encoded small RNA and cell surface markers. The patient was subsequently administered immunosuppressive therapy with a reduced dose of etoposide because of previous organ damage. EBV clearance was confirmed by serial quantification of cell-fractionated EBV-DNA, whereas EBV-DNA persisted in the plasma for 18 weeks. Immunochemotherapy with low-dose etoposide combined with serial viral load monitoring is a potential therapeutic option for severe EBV-hemophagocytic lymphohistiocytosis cases with organ damage.
一名 3 岁男童被临床诊断为 EBV（Epstein-Barr virus）相关噬血细胞性淋巴组织细胞增生症。我们通过外周血 EBV 编码的小 RNA 和细胞表面标志物的细胞学双重染色来识别 EBV 感染的 CD8 阳性 T 淋巴细胞。由于先前的器官损伤，该患者随后接受了免疫抑制治疗，使用了小剂量依托泊苷。通过对细胞分离 EBV-DNA 的连续定量来确认 EBV 清除，而 EBV-DNA 在血浆中持续了 18 周。低剂量依托泊苷联合免疫化学疗法和连续病毒载量监测是一种有希望的治疗选择，适用于有器官损伤的严重 EBV-噬血细胞性淋巴组织细胞增生症病例。
