Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021345 (infectious mononucleosis)
 3,358 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It has been postulated that human cytomegalovirus (HCMV) infection may have a role in the pathogenesis of common variable immunodeficiency (CVID). Many patients have a lymphocyte phenotype similar to that seen in HCMV infection, HCMV mononucleosis may precipitate hypogammaglobulinaemia, and a previous small study of common variable immunodeficient patients reported a high rate of active HCMV infection. This study investigated the presence and activity of HCMV infection in 102 CVID patients. Buffy coats were examined for the presence of HCMV IE and glycoprotein B genes using highly sensitive nested PCR. 30 blood donors of known HCMV serologic status were used as controls. There was no significant difference in HCMV positivity by PCR between patients and controls. Enrichment for mononuclear cells prior to PCR had no effect on sensitivity. Twenty-five patients were also examined for HCMV antigenaemia by staining buffy coat cytospins with monoclonal antibodies directed against the HCMV pp65 lower matrix protein, a technique widely used for diagnosis of active HCMV disease. Only one patient was positive (and also positive by PCR). Whilst these results do not exclude prior infection contributing to antibody deficiency in a small proportion of CVID patients, this study refutes the previously reported increase in active HCMV infection in CVID.
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PMID:Human cytomegalovirus infection is not increased in common variable immunodeficiency. 888 96

The Epstein-Barr virus (EBV) is the best characterized human virus known to infect most people all over the world. In most cases, primary infection with EBV is asymptomatic and the virus persists life-long without causing any disease. The availability of sensitive detection methods, however has led to the identification of a wide array of EBV-associated disease entities. Although nearly 9000 publications have been written since the first description of this virus in 1964, many questions concerning its function and infection patterns remain unanswered. The direct involvement of EBV in the pathogenesis of a disease has only been established for infectious mononucleosis and lymphoproliferative disorders in the setting of congenital or acquired immunodeficiency. Extensive investigations on the role of EBV infection in the pathogenesis of all other EBV-associated lymphoid and epithelial proliferations have led to the conclusion that EBV is not the primary causative agent but it can promote tumour development. Since the early steps in neoplastic development are difficult to assess, further studies are required to clarify the precise role of EBV infection. Furthermore, the clinical significance of the presence of EBV in neoplasia is largely unknown.
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PMID:Epstein-Barr virus in tumours. 891 38

Syphilis has once again become a public health issue with the advent of human immunodeficiency virus (HIV) infection. We report a 28-year-old Chinese man with recently acquired HIV infection together with early neurosyphilis. His presentation of acute mononucleosis-like syndrome, lymphadenopathy, aseptic meningitis, positive central nervous syndrome and reactive Venereal Disease Research Laboratory test in his cerebrospinal fluid helped to reach the diagnosis. Paired serum Western blot tests for HIV infection performed 1 month apart revealed either a new appearance or an increasing intensity of bands for p17, p24, p31, gp41, p52, p55, p68, gp120 and gp160 suggesting recently acquired HIV infection. The lymphadenopathy disappeared spontaneously and the neurosyphilis responded well to 14 days of penicillin G therapy. The Western blot pattern, clinical course, laboratory data, and therapeutic response indicated that the acute retroviral syndrome and early central nervous system involvement caused by Treponema pallidum occurred concomitantly.
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PMID:Concomitant human immunodeficiency virus infection and syphilitic meningitis. 906 8

Symptomatic primary human immunodeficiency virus (HIV) infection was originally defined as a mononucleosis-like syndrome, with or without lymphocytic meningitis, associated with seroconversion for HIV. However, other protean clinical manifestations have been reported, and diagnosis should be considered in patients with risk factors for HIV who experience acute infectious illness, requiring search for p24 antigenemia and development of HIV antibodies. The clinical presentation of symptomatic HIV infection could predict the subsequent disease progression. In several studies, it is associated with poor prognosis. Pathogenesis relies on the host immune response and on virologic parameters. Early antiretroviral therapy on acute HIV infection could modify the course of infection.
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PMID:[Symptomatic primary human immunodeficiency virus infection]. 909 16

The purpose of this study was to describe the frequency and duration of clinical features at the time of acute human immunodeficiency virus type 1 (HIV-1) disease in 218 patients with documented symptomatic primary HIV-1 infection. The mean duration of acute HIV-1 disease was 25.1 days (median, 20.0 days) and did not differ by gender, age, and risk factor. The frequency and mean duration of clinical features occurring in >50% of patients were as follows: fever, 77.1% and 16.9 days; lethargy, 65.6% and 23.7 days; cutaneous rash, 56.4% and 15 days; myalgia, 54.6% and 17.7 days; and headache, 50.9% and 25.8 days. Only 15.6% of patients presented with a typical mononucleosis-like illness (MLI) defined as fever, pharyngitis or sore throat, and cervical adenopathy, and 10% had no features of an MLI. A meningitis-like syndrome occurred in 20 patients (9.2%). Acute HIV-1 disease is more diverse than previously reported, and the absence of fever or other MLI features does not rule out acute HIV-1 disease.
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PMID:Acute human immunodeficiency virus type 1 disease as a mononucleosis-like illness: is the diagnosis too restrictive? 914 2

The authors report seven cases of cytomegalovirus lymphadenitis in apparently immunocompetent patients. One patient presented with an infectious mononucleosis-like illness. The main presentation of the others was isolated cervical lymphadenopathies. The lymph node pathology showed aspecific lymphoid hyperplasia, resembling the human immunodeficiency virus related lymphadenopathy, associated with diagnostic inclusion cells. Infected cells were confined to areas of monocytoid B cell hyperplasia in all cases whereas exceptionally observed in germinal centers. Because of their variable appearance, serial sectioning was frequently necessary to disclose their characteristic features. In all cases, immunohistochemistry using an anti-cytomegalovirus antibody was positive and revealed more infected cells than detected by morphology alone. Except for the endothelial cell, the nature of infected cells remained undetermined. An alteration of the antigenic expression as a consequence of cell infection might be responsible for immunohistochemistry failure in the cell characterization.
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PMID:[Histopathologic features of cytomegalovirus lymphadenitis in the "immunocompetent" patient. Report of 7 cases]. 917 13

Primary infection by type 1 human immunodeficiency virus (HIV) is symptomatic in about 70% of cases. The acute illness is a mononucleosis-like syndrome with characteristics such as mucosal ulcerations. The duration and severity of the symptoms appear to be related to the prognosis. After reviewing the most frequent signs and symptoms of primary HIV infection, we report different prognostic studies which examined the association between the acute illness and the progression of HIV disease.
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PMID:Primary infection by type 1 human immunodeficiency virus: diagnosis and prognosis. 933 24

The Epstein-Barr virus (EBV) was isolated 40 years ago from cultures of Burkitt lymphoma cells (BL). The tumor was encountered in Africa and exhibited characteristical geographical, clinical and pathological features. Serological studies revealed that the virus is ubiquitous in humans. The primary infection is often accompanied by the syndrome of acute infectious mononucleosis (IM). It can induce malignant proliferation of B lymphocytes in conditions of immunodeficiency. EBV can immortalize B lymphocytes in culture. These cells carry the virus as episomes and express 9 virally encoded proteins. Their immunological recognition constitutes the surveillance which is responsible for the healthy virus carrier state. The main virus reservoir is represented by a low number of resting B lymphocyte which contain the viral genome but do not express its transformation proteins. The viral genome is detectable in all African BLs, in variable proportions of nasopharyngeal carcinoma, Hodgkin's disease, T cell lymphoma, lymphoepithelial like carcinoma, gastric carcinoma and leiomyosarcoma cases. The role of EBV in the genesis of these tumors is unknown.
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PMID:The complexity of the Epstein-Barr virus infection in humans. 955 13

Epstein-Barr virus (EBV)-associated lymphoproliferative diseases are a frequent occurrence in immunodeficient patients. Most commonly seen are polymorphic B-cell lymphoproliferative disorders and malignant B-cell lymphomas. Classical Hodgkin's disease (HD), however, is rare in these patients. In the present study, we attempted to characterize cases resembling HD in patients with a variety of underlying immunodeficiency states using clinical aspects, immunohistochemistry, in situ hybridization, and polymerase chain reaction. All of the six cases that we investigated presented clinically with B symptoms and a short, devastating course. Histologically, they showed a lymphocytic depletion and multiple cells that resembled HD and Reed-Sternberg cells. Many of those were atypical blast cells that stained positively for B-cell surface antigens, such as CD20 and CD79a, whereas others were of the typical HD and Reed-Sternberg phenotype. Another frequent finding, especially in the extranodal sites, was a perivascular arrangement of large blast cells intermingled with small lymphoid cells. All of the cases were EBV-associated (proved latent membrane protein-1 immunohistochemical analysis, EBV-encoded RNA in situ hybridization, and polymerase chain reaction for subtypes A and B), with a frequent coinfection of type A and B. This was in contrast to ordinary HD, which is characterized by single infection of only one strain, i.e., the subtype A in Western countries. Three cases showed clonal B-cell populations, at least at terminal stages of the disease. We describe a lymphoproliferative disorder in immunodeficient patients with features of HD that, in some respects, resembles an EBV-driven lymphoproliferative disorder seen in cases of fatal infectious mononucleosis. We conclude that clinical and pathologic features of these disorders might cause some problems for histologic differential diagnosis and might represent a separate entity of their own in immunodeficient patients.
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PMID:Hodgkin's disease-like lymphoproliferative disorders in patients with different underlying immunodeficiency states. 957 79

X-linked lymphoproliferative disease (XLP) is a rare familial disorder resulting in selective immunodeficiency to the Epstein-Barr virus (EBV), characterized by uncontrolled proliferation of EBV-infected lymphocytes. Phenotypes of this disease are variable and include fulminant infectious mononucleosis, hypogammaglobulinemia, and malignant lymphoma. In this article, we describe a case of a previously healthy 4-year-old boy with serologic evidence of acute EBV infection who died of fulminant hepatic failure. Histopathological examination of tissue obtained postmortem showed hemophagocytosis and prominent polymorphous infiltrates associated with necrosis in the liver, spleen, and lymph nodes. Semiquantitative polymerase chain reaction (PCR) utilizing primers complementary to the EBV gene LMP2a performed on samples of liver tissue demonstrated approximately 0.6 copies of the EBV gene per cell. Immunohistochemistry demonstrated light chain restriction and PCR studies of the immunoglobulin V-D-J region revealed two strong bands, consistent with a clonal B cell proliferation. Extended family history revealed that the boy's family was followed by the XLP Registry, which was established in 1978 to follow kindreds with XLP. The genetic abnormality associated with XLP has been localized to the Xq25, allowing RFLP analysis to identify female carriers and affected boys.
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PMID:X-linked lymphoproliferative disease: pathology and diagnosis. 984 10


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