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Inaba Y, Miyazono A, Imadome K, Aratake S, Okamoto Y. A successful treatment for chronic active Epstein-Barr virus disease with Nephrotic Syndrome. CEN Case Rep 2023:10.1007/s13730-023-00815-5. [PMID: 37668889 DOI: 10.1007/s13730-023-00815-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/02/2023] [Indexed: 09/06/2023] Open
Abstract
Chronic active Epstein-Barr virus (CAEBV) disease is more likely to occur when a patient is on immunosuppressive therapy for any disease or is susceptible to infection, and the prognosis is poor without appropriate treatment, including hematopoietic stem cell transplantation (HSCT). In addition to HSCT, several other chemotherapy regimens have been reported, but all of them are difficult to maintain in remission. Without HSCT, survival rates have been reported to be 50% in 5 years and 25% in 15 years. This is a report of a 13-year-old boy who developed CAEBV disease during cyclosporine A (CyA) treatment for the steroid-dependent nephrotic syndrome (SDNS). Since SDNS precluded HSCT or chemotherapy, CyA was tapered off based on the belief that alleviating his immunosuppressed state would decrease the CAEBV disease. We decided to gradually reduce the CyA dose to activate T-cell immunity, while periodically monitoring the EBV viral load. Finally, we found an appropriate dose that could suppress both CAEBV disease and SDNS, and it lasted for more than 9 years. No case has been reported to date in which a patient developed CAEBV disease while receiving immunosuppressive drugs for the primary disease, and both diseases were controlled only by reducing the dose of immunosuppressive drugs. In this report, we show that dose reduction of immunosuppressive agents without chemotherapy or HSCT is an effective option for the treatment of CAEBV disease in patients receiving immunosuppressive agents.
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Affiliation(s)
- Yasuhiro Inaba
- Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8520, Japan.
| | - Akinori Miyazono
- Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8520, Japan
| | - Kenichi Imadome
- Department of Advanced Medicine for Infections, National Center for Child Health and Development (NCCHD), Tokyo, Japan
| | - Shinji Aratake
- Department of Pediatrics, National Hospital Organization Ibuski Medical Center, Ibuski, Japan
| | - Yasuhiro Okamoto
- Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8520, Japan
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Fukushima N, Sakaguchi H, Toda K, Kogaki S, Narita J, Ishida H, Hashii Y, Miyamura T, Imadome K. Simultaneous Assessment of Plasma and Peripheral Mononuclear Cells for Multiple Viral Load Quantification in Peripheral Blood of Patients after Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Tokoro S, Namiki T, Miura K, Watanabe K, Arai A, Imadome K, Yokozeki H. Chronic active Epstein-Barr virus infection with cutaneous lymphoproliferation: haemophagocytosis in the skin and haemophagocytic syndrome. J Eur Acad Dermatol Venereol 2017; 32:e116-e117. [PMID: 29024023 DOI: 10.1111/jdv.14640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Tokoro
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - T Namiki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - K Miura
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - K Watanabe
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - A Arai
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.,Department of Laboratory Molecular Genetics of Hematology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - K Imadome
- Department of Advanced Medicine for Infections, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - H Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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Nakayama F, Umeda S, Fujita M, Imadome K, Kawano M, Koike S, Miura T, Yasuda T, Masuzawa M, Imai T. 605 Strong FGF1 signaling inhibits the proliferation, invasion and migration of murine angiosarcoma cell line ISOS-1. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Onishi Y, Sugimura K, Ohba R, Imadome K, Shimokawa H, Harigae H. Resolution of chronic active EBV infection and coexisting pulmonary arterial hypertension after cord blood transplantation. Bone Marrow Transplant 2014; 49:1343-4. [PMID: 24955786 DOI: 10.1038/bmt.2014.129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Y Onishi
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - K Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - R Ohba
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - K Imadome
- Department of Infectious Diseases, National Research Institute for Child Health and Development, Tokyo, Japan
| | - H Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - H Harigae
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
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Shigeta T, Imadome K, Sakamoto S, Fukuda A, Kakiuchi T, Matsuno N, Tanaka H, Nakazawa A, Kasahara M. Epstein-Barr Virus Infection after Pediatric Living-Related Liver Transplantation—Management and Risk Factors. Transplant Proc 2010; 42:4178-80. [DOI: 10.1016/j.transproceed.2010.09.134] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 09/29/2010] [Indexed: 11/15/2022]
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Tamaki T, Iwakawa M, Ohno T, Imadome K, Sakai M, Nakawatari M, Nojiri K, Tsujii H, Nakano T, Imai T. Anti-Metastatic Effect of Local Carbon-Ion Irradiation in a Highly Metastatic Mouse Model. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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