Shin Yong Woo, Sunwoo Jun-Sang, Lee Han-Sang, Lee Woo-Jin, Ahn Seon-Jae, Lee Sang Kun, Chu Kon
Department of Neurology, Comprehensive Epilepsy Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Laboratory for Neurotherapeutics, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
Encephalitis. 2022 Jan;2(1):1-8. doi: 10.47936/encephalitis.2021.00115. Epub 2021 Nov 17.
Epstein-Barr virus (EBV) is implicated in various neurological conditions. However, the relationship between EBV DNA in cerebrospinal fluid (CSF) and central nervous system (CNS) infection is unclear. We evaluated the clinical manifestation of patients with EBV DNA detected in CSF.
We reviewed the medical records of patients admitted to Seoul National University Hospital from January 2000 to March 2021 who underwent EBV polymerase chain reaction (PCR) tests in CSF. The subjects were divided into positive and negative groups depending on the presence of EBV DNA, and further clinical information was obtained from positive patients.
CSF EBV PCR tests were performed in 807 patients, and 57 (7.1%) tested positive. Pleocytosis was common (81.1%) in CSF samples with EBV DNA detected, and the proportion was significantly higher than that in samples that were EBV PCR negative (44.5%, p < 0.0001). Among 57 patients with EBV DNA detected in CSF, 51 (89.5%) were diagnosed with CNS infection or inflammatory disorders. Of the 51 patients, 31 (60.8%) had possible etiologies other than EBV. Follow-up evaluation was conducted in 19 of 20 patients, and 63.2% showed a favorable outcome.
Positive EBV PCR in CSF is mostly nonspecific and should be interpreted with caution. A comprehensive workup is needed to identify other etiologies before considering EBV as the sole culprit.
爱泼斯坦-巴尔病毒（EBV）与多种神经系统疾病有关。然而，脑脊液（CSF）中的EBV DNA与中枢神经系统（CNS）感染之间的关系尚不清楚。我们评估了脑脊液中检测到EBV DNA的患者的临床表现。
我们回顾了2000年1月至2021年3月在首尔国立大学医院住院并接受脑脊液EBV聚合酶链反应（PCR）检测的患者的病历。根据EBV DNA的存在情况将受试者分为阳性和阴性组，并从阳性患者中获取进一步的临床信息。
对807例患者进行了脑脊液EBV PCR检测，其中57例（7.1%）检测呈阳性。在检测到EBV DNA的脑脊液样本中，细胞增多症很常见（81.1%），该比例显著高于EBV PCR阴性样本（44.5%，p<0.0001）。在脑脊液中检测到EBV DNA的57例患者中，51例（89.5%）被诊断为中枢神经系统感染或炎症性疾病。在这51例患者中，31例（60.8%）有除EBV以外的可能病因。对20例患者中的19例进行了随访评估，63.2%的患者预后良好。
脑脊液中EBV PCR阳性大多是非特异性的，应谨慎解读。在将EBV视为唯一病因之前，需要进行全面检查以确定其他病因。
