A Rapid Cytologic Double Staining of Epstein-Barr Virus-encoded Small RNA and Cell Surface Markers for Diagnosis of Epstein-Barr Virus-associated Hemophagocytic Lymphohistiocytosis
A Rapid Cytologic Double Staining of Epstein-Barr Virus-encoded Small RNA and Cell Surface Markers for Diagnosis of Epstein-Barr Virus-associated Hemophagocytic Lymphohistiocytosis
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用于诊断 Epstein-Barr 病毒相关噬血细胞性淋巴组织细胞增多症的 Epstein-Barr 病毒编码小 RNA 和细胞表面标记物的快速细胞学双重染色
DOI：
10.1097/mph.0000000000001647
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Ito E.
中科院分区：
文献类型：
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作者：
Takahashi N;Kudo K;Tanaka M;Kumagai N;Sato T;Kamio T;Sasaki S;Terui K;Kurose A;Yanagisawa R;Nakazawa Y;Ito E.
1例3岁男童被临床诊断为EB病毒相关性噬血细胞淋巴组织细胞增生症。我们通过外周血中EBV编码的小RNA和细胞表面标志的细胞学双重染色来鉴定EBV感染的CD8阳性T淋巴细胞。由于先前的器官损害，患者随后接受了免疫抑制治疗，并减少了依托泊苷的剂量。EBV清除是通过连续定量细胞分离的EBV-DNA来确认的，而EBV-DNA在血浆中持续了18周。小剂量依托泊苷联合系列病毒载量监测的免疫化疗是治疗严重EBV-噬血细胞淋巴组织细胞增多症合并器官损害的潜在治疗选择。
A 3-year-old boy was clinically diagnosed with Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis. We identified EBV-infected CD8-positive T-lymphocytes by cytologic double staining of the peripheral blood for EBV-encoded small RNA and cell surface markers. The patient was subsequently administered immunosuppressive therapy with a reduced dose of etoposide because of previous organ damage. EBV clearance was confirmed by serial quantification of cell-fractionated EBV-DNA, whereas EBV-DNA persisted in the plasma for 18 weeks. Immunochemotherapy with low-dose etoposide combined with serial viral load monitoring is a potential therapeutic option for severe EBV-hemophagocytic lymphohistiocytosis cases with organ damage.