Division of Hematology, Jichi Medical University Saitama Medical Center, Japan.
Division of Hematology, Department of Medicine, Jichi Medical University, Japan.
J Infect Chemother. 2023 Feb;29(2):212-218. doi: 10.1016/j.jiac.2022.10.013. Epub 2022 Oct 28.
Chronic active Epstein-Bar virus infection (CAEBV) is known to cause various symptoms. Although pulmonary artery hypertension (PAH) has been reported as a cardiovascular complication of CAEBV, the mechanisms of PAH and the effects of treatment have not been fully elucidated. We experienced 4 adult patients with CAEBV complicated by PAH. All of them received treatment for PAH with a vasodilator followed by chemotherapy with or without allogeneic hematopoietic cell transplantation for CAEBV. In all of these patients, the transtricuspid pressure gradient improved under treatment with vasodilator, and further improvement was observed under treatment for CAEBV in 3 patients. Autopsy was performed in 2 patients, which revealed EBER-positive cells and a change in the pulmonary artery at each stage in the pathology. In conclusion, EBV-infected cells can cause vasculitis and finally PAH. However, PAH complicated with CAEBV can be improved by PAH medication and treatment of CAEBV.
慢性活动性 EBV 感染（CAEBV）可引起多种症状。尽管肺动脉高压（PAH）已被报道为 CAEBV 的心血管并发症，但 PAH 的发病机制和治疗效果尚未完全阐明。我们共诊治了 4 例 CAEBV 合并 PAH 的成年患者。所有患者均接受了 PAH 的血管扩张剂治疗，随后根据 CAEBV 情况选择化疗或异基因造血细胞移植。在所有患者中，血管扩张剂治疗后跨三尖瓣压力梯度改善，3 例患者在 CAEBV 治疗后进一步改善。2 例患者接受了尸检，病理学检查发现每个阶段均存在 EBV 阳性细胞和肺动脉的改变。总之，EBV 感染的细胞可引起血管炎，最终导致 PAH。然而，CAEBV 合并 PAH 可通过 PAH 药物治疗和 CAEBV 治疗得到改善。
