Marzo 2019 - Volume XXXVIII - numero 3

Medico e Bambino


Problemi speciali

Manifestazioni dell’infezione da virus di Epstein-Barr nel paziente con immunodeficit

Fiammetta Zunica1, Francesco Saettini2, Andrea Biondi2, Raffaele Badolato1

1Clinica Pediatrica, Università di Brescia
2Clinica Pediatrica, Università di Milano-Bicocca

Indirizzo per corrispondenza: raffaele.badolato@unibs.it

Clinical features of Epstein-Barr virus infection in primary immunodeficiency patients

Key words: EBV, PID, Splenomegaly, Hypogammaglobulinemia, APDS

Recurrent respiratory infections are frequent in healthy children. The association with peculiar signs and symptoms such as splenomegaly, lymphopenia, and hypogammaglobulinemia should induce suspicion of primary immunodeficiency (PID). The described case is an example of early detection of PID due to heterozygous gain of function mutation of the gene coding for p110􀀀 PI3K subunit responsible for APDS (activation PI3 kinase delta syndrome). Recently recognized, APDS is a combined immunodeficiency characterised by recurrent pulmonary infections, CMV and EBV viremia and lymphadenopathy. The typical immunological pattern of this syndrome is: hypogammaglobulinemia characterised by altered levels of IgM (more often increased but sometimes normal or decreased levels have been reported) associated with reduction in IgG and IgA levels; altered distribution of the T cell subsets (CD4+ lymphopoenia) and anomalous compartment B (expansion of transitional B cells and reduction in memory B cells). In the reported case, although the patient presented with an incomplete phenotype, early diagnosis was guided by the immuno-disregulation red flags (splenomegaly, chronic EBV viremia and persistent otorrhea) and therapy was promptly instituted in order to reduce the onset of long-term complications.

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F. Zunica, F. Saettini, A. Biondi, R. Badolato Manifestazioni dell’infezione da virus di Epstein-Barr nel paziente con immunodeficit. Medico e Bambino 2019;38(3):163 https://www.medicoebambino.com/?id=1903_163.pdf


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