Author(s)

Esther Manor, Yonat Shemer-Avni, Sophia Boriakovski, Michael Kafka, Lipa Bodner, Joseph Kapelushnik

Soroka Medical Center, Department of Hematology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Soroka Medical Center, Department of Oral and Maxillofacial Surgery, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Soroka Medical Center, Department of Pediatric Hemato-Oncology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Soroka Medical Center, Faculty of Health Sciences, Institute of Human Genetics, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Soroka Medical Center, Laboratory for Viral Diagnosis, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Background: Epstein Barr Virus (EBV) is associated with different kinds of tumors. In the present study we tried to understand its role in pediatric MDS of a 4-year-old girl with EBV infection and MDS with refractory anemia and monosomy 7. Procedures: The work-up included: hematological tests; serology for IgM, IgG antibodies to EBV; PCR for EBV; cytogenetics of bone marrow (BM), and FISH analysis of BM and blood; immunohistochemistry-LMP1 expression on BM smears. Results: Hematological follow up showed constant mild dysplastic changes mostly in the erythroid lineage. PCR for EBV showed positive results in the nasopharygeal smears as well as in blood 15 weeks after disease onset. Cytogenetic analysis showed monosomy7 inall the mitoses of BM sample. Fluorescence in situ hybridization (FISH) showed monosomy 7% in 57% of the cells, followed by a decreased tendency in the percentage of monosomy 7 cells in both BM and blood. Immunohistochemistry for EBV-latent membrane protein 1 (LMP-1) on the patient’s BM smears, 21 weeks post disease onset, showed 9% positive cells, 80% of them carried monosomy 7. Conclusion: The parallel occurrence of the EBV infection and MDS, as well as the continuous EBV PCR positive and monosomy 7, support the possibility that they are related.

Pediatric, MDS, EBV Infection

Manor, E. , Shemer-Avni, Y. , Boriakovski, S. , Kafka, M. , Bodner, L. and Kapelushnik, J. (2013) Myelodysplastic syndrome (MDS) associated with EBV infection in a pediatric patient. Open Journal of Pediatrics, 3, 28-34. doi: 10.4236/ojped.2013.31006.