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A 73-year-old woman with erythematous nodules was admitted to our hospital in December 2003. She was diagnosed with polyarteritis nodosa (PAN) from skin biopsy and laboratory data. Following the treatment with oral prednisolone (40 mg/day), her condition improved. Four days after the reduction of prednisolone, she became febrile. Bone marrow aspiration revealed an increase in the number of marrow macrophages, and phagocytosis of blood cells. The Epstein–Barr virus genome was detected in her peripheral blood. A diagnosis of hemophagocytic syndrome was made. Moreover, intestinal bleeding developed and the patient was given medical treatment consisting of methylprednisolone pulse therapy, intravenous immunoglobuline, weekly intravenous VP-16, and several blood transfusions. In addition, embolization of a branch of the ileal artery was performed. Despite the above treatments, the patient died. Autopsy revealed hemophagocytosis in bone marrow and perforation of ileocecal region. This case suggests that risks for hemophagocytic syndrome in PAN patients should be recognized. [ABSTRACT FROM AUTHOR]

Oz Puyan F, Bilgi S, Unlu E, Yalcin O, Altaner S, Demir M, Cakir B. Inflammatory pseudotumor of the spleen with EBV positivity: report of a case. Eur J Haematol 2004: 72: 285–291. © Blackwell Munksgaard 2004. Inflammatory pseudotumor (IPT) of the spleen is a rare benign tumor with unknown etiology. It causes problems in the diagnosis because of mimicking some hematopoetic malignancies. Here we report the case of a 36-yr-old woman complaining of nausea and insomnia. Laboratory investigations were limited to increase of leukocyte and thrombocyte count. Ultrasonography and magnetic resonance (MR) imaging showed circumscribed solid lobulated mass, measuring about 6.5 cm in diameter, located in the dorsal region of the spleen. Splenectomy was performed with the differential diagnosis including hamartoma and lymphoma of the spleen. Histological examination of the sharply demarcated splenic mass consisted of myofibroblasts and admixture of inflammatory cells. Immunohistochemistry and in situ hybridization were performed. IPT of the spleen was diagnosed. Epstein–Barr virus (EBV) was detected in the tumor by in situ hybridization. This rare entity is presented because of its clinical, radiological and pathological difficulties in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Takeoka Y, Nakao Y, Ueda M, Koh K-R, Aoyama Y, Nakamae H, Yamamura R, Ohta K, Takubo T, Yamane T, Hino M, Tokura Y, Ishihara S, Oshima K, Kimura H, Imashuku S. A case of a long-time survivor with chronic active Epstein–Barr virus infection. Eur J Haematol 2004: 72: 73–76. © Blackwell Munksgaard 2004. Epstein–Barr virus (EBV) is associated with hypersensitivity to mosquito bites (HMB) and fatal EBV-associated hemophagocytic syndrome (HPS). The prognosis of patients with chronic active EBV infection (CAEBV) is very poor. We report a rare case of an adult woman patient with a 28-yr history of HMB, who developed EBV-HPS. EBV genome was detected in the serum and peripheral blood lymphocytes. Clonal proliferation of EBV was demonstrated by Southern blot analysis using an EBV genome terminal-repeat probe. This is a very rare case of a long-term survivor with CAEBV. The patient was initially treated with immunochemotherapy and achieved complete remission. However, the patient immediately relapsed and underwent allogeneic bone marrow transplantation (BMT) from her HLA-matched brother. Peripheral blood cell recovered well, and EBV genome disappeared from the peripheral blood. Allogeneic BMT may be effective in eradicating EBV-HPS. Unfortunately, the patient died of graft vs. host disease on the 92nd day after BMT. [ABSTRACT FROM AUTHOR]

A review of the book "Cancer Virus: The Story of Epstein-Barr Virus," by Dorothy H. Crawford, Alan Rickinson, and Ingólfur Johannessen, is presented.

Reviews the book 'Epstein-Barr Virus Protocols,' edited by Joanna B. Wilson and Gerhard H.W. May.

The article reviews the book "The Epstein-Barr Virus," edited by Erle S. Robertson.

Barshes NR, Lee TC, Karpen SJ, Bristow LJ, Quiros-Tejeira RE, Goss JA. Asymptomatic small bowel intussusception associated with post-transplant lymphoproliferative disease. Pediatr Transplantation 2004: 8: 196–197. © 2004 Blackwell Munksgaard A 2-yr-old boy who had undergone orthotopic liver transplantation for biliary atresia 6 months prior presented with generalized lymphadenopathy. Physical exam revealed lymphadenopathy only; the patient had no gastrointestinal signs or symptoms. CT was used to evaluate the patient's lymphadenopathy. The findings were consistent with PTLD, and an incidental intussusception causing small bowel obstruction was found. The intussusception was successfully managed expectantly, and the patient's PTLD responded to administration of rituximab. The etiology, diagnosis and management of intussusception is discussed. [ABSTRACT FROM AUTHOR]

Reviews the report `Detection of Epstein-Barr Virus and Cytomegalovirus in Patients with Chronic Fatigue,' by Betty B. Wray, Claudia Gaughf, Francis W. Chandler, Jr., Suzanne S. Berry, Jeanine E. Latham, Lisa Wood and Robert H. DuRant.

The article reviews the book "Epstein-Barr Virus," edited by Erle S. Robertson.

The article reviews the book "Epstein-Barr Virus," edited by Alex Tselis and Hal B. Jenson.

The article reviews the book "Epstein-Barr Virus: Infectious Disease and Therapy," edited by Alex Tselis and Hal B. Jenson.

The article reviews the book "Human Herpesviruses."

Reviews the book 'The Epstein-Barr Virus,' edited by M.A. Epstein and B.G. Achong.