Central nervous system complications and neuroradiological findings in children with chronic active <scp>E</scp>pstein–<scp>B</scp>arr virus infection

Ishikawa, Nobutsune; Kawaguchi, Hiroshi; Nakamura, Kazuhiro; Kobayashi, Masao

doi:10.1111/ped.12024

Cited by 6 publications

(3 citation statements)

References 30 publications

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“…In rare cases, which are often related to immunodeficiencies, EBV develops a chronic active infection [46]. Chronic active EBV infection is associated with several complications, including central nervous system involvement [26]. The series of 10 cases with chronic active EBV by Ishikawa et al found that 1 patient had bilateral BGC [26].…”

Section: Acquired Infections Epstein-barr Virus (Chronic Active)mentioning

confidence: 99%

Infectious Diseases and Basal Ganglia Calcifications: A Cross-Sectional Study in Patients with Fahr’s Disease and Systematic Review

Snijders,

Peters,

van den Brink

et al. 2024

JCM

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Background: It is unclear whether patients with basal ganglia calcifications (BGC) should undergo infectious disease testing as part of their diagnostic work-up. We investigated the occurrence of possibly associated infections in patients with BGC diagnosed with Fahr’s disease or syndrome and consecutively performed a systematic review of published infectious diseases associated with BGC. Methods: In a cross-sectional study, we evaluated infections in non-immunocompromised patients aged ≥ 18 years with BGC in the Netherlands, who were diagnosed with Fahr’s disease or syndrome after an extensive multidisciplinary diagnostic work-up. Pathogens that were assessed included the following: Brucella sp., cytomegalovirus, human herpesvirus type 6/8, human immunodeficiency virus (HIV), Mycobacterium tuberculosis, rubella virus, and Toxoplasma gondii. Next, a systematic review was performed using MEDLINE and Embase (2002–2023). Results: The cross-sectional study included 54 patients (median age 65 years). We did not observe any possible related infections to the BGC in this population. Prior infection with Toxoplasma gondii occurred in 28%, and in 94%, IgG rubella antibodies were present. The positive tests were considered to be incidental findings by the multidisciplinary team since these infections are only associated with BGC when congenitally contracted and all patients presented with adult-onset symptoms. The systematic search yielded 47 articles, including 24 narrative reviews/textbooks and 23 original studies (11 case series, 6 cross-sectional and 4 cohort studies, and 2 systematic reviews). Most studies reported congenital infections associated with BGC (cytomegalovirus, HIV, rubella virus, Zika virus). Only two studies reported acquired pathogens (chronic active Epstein–Barr virus and Mycobacterium tuberculosis). The quality of evidence was low. Conclusions: In our cross-sectional study and systematic review, we found no convincing evidence that acquired infections are causing BGC in adults. Therefore, we argue against routine testing for infections in non-immunocompromised adults with BGC in Western countries.

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Section: Acquired Infections Epstein-barr Virus (Chronic Active)mentioning

confidence: 99%

Infectious Diseases and Basal Ganglia Calcifications: A Cross-Sectional Study in Patients with Fahr’s Disease and Systematic Review

Snijders,

Peters,

van den Brink

et al. 2024

JCM

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“…There have been several reports on systemic organ involvement in each individual suffering CAEBV, mainly from Japan . Although the detailed mechanism of systemic organ involvement is not fully understood, a direct insult to the organ by EBV or exposure to inflammatory cytokines produced by EBV‐infected T cells or natural killer cells has been postulated to play a central role . Cardiovascular complications include coronary artery lesion, aortitis, carditis, atrioventricular block, and sudden death, and are significant indicators of mortality .…”

mentioning

confidence: 99%

“…Ishikawa et al . reported that half of the patients had neurological symptoms, including posterior reversible encephalopathy syndrome with epilepsy, basal ganglia calcification, and falx cerebri hemorrhage . Generalized myositis mimicking polymyositis is a rarer complication but may sometimes be the initial and main manifestation of CAEBV, and is associated with poor prognosis .…”

mentioning

confidence: 99%

Systemic multi‐organ involvement in chronic active Epstein–Barr virus disease

Kim

Lee

Moon

et al. 2015

Pediatrics International

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Lessons from Epstein-Barr virus DNA detection in cerebrospinal fluid as a diagnostic tool for EBV-induced central nervous system dysfunction among HIV-positive patients

Wang

Yang

Wen

2022

Biomedicine & Pharmacotherapy

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Central nervous system complications and neuroradiological findings in children with chronic active Epstein–Barr virus infection

Abstract: This study revealed that various central nervous system complications may occur during the clinical course in pediatric CAEBV patients.

Cited by 6 publications

References 30 publications

Infectious Diseases and Basal Ganglia Calcifications: A Cross-Sectional Study in Patients with Fahr’s Disease and Systematic Review

Infectious Diseases and Basal Ganglia Calcifications: A Cross-Sectional Study in Patients with Fahr’s Disease and Systematic Review

Systemic multi‐organ involvement in chronic active Epstein–Barr virus disease

Lessons from Epstein-Barr virus DNA detection in cerebrospinal fluid as a diagnostic tool for EBV-induced central nervous system dysfunction among HIV-positive patients

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