Imai S, Usui N, Sugiura M, Osato T, Sato T, Tsutsumi H, Tachi N, Nakata S, Yamanaka T, Chiba S
Department of Virology, Hokkaido University School of Medicine, Sappord, Japan.
J Med Virol. 1993 Aug;40(4):278-84. doi: 10.1002/jmv.1890400405.
Four children with infectious mononucleosis (IM) and one with reactivated Epstein-Barr virus (EBV) infection had concomitant central nervous system disorders. Cerebrospinal fluid (CSF) samples from all five patients contained EBV genomic sequences and EBV-specific antibodies in the neurologic stage, but not during convalescence. Cerebrospinal fluid from two non-neurologic IM patients had neither EBV DNA nor EBV antibodies. The EBV-positive CSF of the five with neurological disorders were aseptic in culture and all negative for other human herpesvirus DNAs and antibodies: herpes simplex virus types 1 and 2, cytomegalovirus, varicella-zoster virus, and human herpesvirus 6. Epstein-Barr virus DNA and EBV antibodies were not detected in the CSF of 17 EBV-seropositive patients with mumps meningitis, rubella encephalitis, unknown febrile convulsion, or partial epilepsy. It is suggested that EBV plays a causal role in neurologic manifestations in patients with acute and reactivated EBV infections, through direct viral invasion and immunopathological reactions.
4名传染性单核细胞增多症（IM）患儿和1名EB病毒（EBV）再激活感染患儿伴有中枢神经系统疾病。所有5例患者的脑脊液（CSF）样本在神经症状期均含有EBV基因组序列和EBV特异性抗体，但恢复期则没有。2例非神经症状IM患者的脑脊液既没有EBV DNA也没有EBV抗体。5例有神经系统疾病患者的EBV阳性脑脊液培养无菌，其他人类疱疹病毒DNA和抗体均为阴性：1型和2型单纯疱疹病毒、巨细胞病毒、水痘带状疱疹病毒和人类疱疹病毒6型。在17例患有腮腺炎脑膜炎、风疹脑炎、不明热性惊厥或部分癫痫的EBV血清阳性患者的脑脊液中未检测到EBV DNA和EBV抗体。提示EBV通过直接病毒侵袭和免疫病理反应在急性和再激活EBV感染患者的神经表现中起因果作用。
