Epstein–Barr Virus Prevalence at Diagnosis and Seroconversion during Follow-Up in Pediatric Inflammatory Bowel Disease

Primary Epstein–Barr virus infection in pediatric patients with inflammatory bowel disease during immunomodulation with thiopurines has been associated with increased risk for malignancies or hemophagocytic lymphohistiocytosis. We determined Epstein–Barr virus (EBV) seroprevalence at inflammatory bo...

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Autores principales:	Jennifer Bachmann, Giang Le Thi, Annecarin Brückner, Anna-Lena Kalteis, Tobias Schwerd, Sibylle Koletzko, Eberhard Lurz
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	inflammatory bowel disease pediatrics thiopurines hemophagocytic lymphohistiocytosis malignancy Medicine R
Acceso en línea:	https://doaj.org/article/3995d3fdb8bc4b9597c7a5026a30ec77
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spelling	oai:doaj.org-article:3995d3fdb8bc4b9597c7a5026a30ec772021-11-11T17:47:40ZEpstein–Barr Virus Prevalence at Diagnosis and Seroconversion during Follow-Up in Pediatric Inflammatory Bowel Disease10.3390/jcm102151872077-0383https://doaj.org/article/3995d3fdb8bc4b9597c7a5026a30ec772021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5187https://doaj.org/toc/2077-0383Primary Epstein–Barr virus infection in pediatric patients with inflammatory bowel disease during immunomodulation with thiopurines has been associated with increased risk for malignancies or hemophagocytic lymphohistiocytosis. We determined Epstein–Barr virus (EBV) seroprevalence at inflammatory bowel disease (IBD) diagnosis and seroconversion during follow-up in a large single center cohort of children with IBD. EBV serology results and patient characteristics were retrospectively retrieved from the hospital documentation system. EBV seronegative patients at IBD diagnosis were prospectively retested. We report on IBD patients with symptomatic active EBV infection and a complicated disease course, and those diagnosed with malignancy with respect to EBV status and drug exposure. Of 402 patients, 194 (48%) had available EBV serology results at time of IBD diagnosis at a median of 12 years (IQR 9–14 years). Thereof, 102 (53%) were EBV-positive. Of 92 EBV-negative patients, 66 were retested and 17% showed a seroconversion at a mean follow-up time of 4.3 years (SD 3 years). Three children treated with azathioprine experienced acute clinically relevant EBV infection 2, 2.5, and 4 years after IBD diagnosis, two developed signs of hemophagocytic lymphohistiocytosis. Three cases of malignancy occurred in the cohort, though none seemed to be triggered by EBV. In conclusion, almost 50% of pediatric IBD patients were EBV-naïve following diagnosis and may be at increased risk to develop severe EBV infection during immunosuppressive therapy, potentially associated with complications such as hemophagocytic lymphohistiocytosis or malignancy.Jennifer BachmannGiang Le ThiAnnecarin BrücknerAnna-Lena KalteisTobias SchwerdSibylle KoletzkoEberhard LurzMDPI AGarticleinflammatory bowel diseasepediatricsthiopurineshemophagocytic lymphohistiocytosismalignancyMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5187, p 5187 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	inflammatory bowel disease pediatrics thiopurines hemophagocytic lymphohistiocytosis malignancy Medicine R
spellingShingle	inflammatory bowel disease pediatrics thiopurines hemophagocytic lymphohistiocytosis malignancy Medicine R Jennifer Bachmann Giang Le Thi Annecarin Brückner Anna-Lena Kalteis Tobias Schwerd Sibylle Koletzko Eberhard Lurz Epstein–Barr Virus Prevalence at Diagnosis and Seroconversion during Follow-Up in Pediatric Inflammatory Bowel Disease
description	Primary Epstein–Barr virus infection in pediatric patients with inflammatory bowel disease during immunomodulation with thiopurines has been associated with increased risk for malignancies or hemophagocytic lymphohistiocytosis. We determined Epstein–Barr virus (EBV) seroprevalence at inflammatory bowel disease (IBD) diagnosis and seroconversion during follow-up in a large single center cohort of children with IBD. EBV serology results and patient characteristics were retrospectively retrieved from the hospital documentation system. EBV seronegative patients at IBD diagnosis were prospectively retested. We report on IBD patients with symptomatic active EBV infection and a complicated disease course, and those diagnosed with malignancy with respect to EBV status and drug exposure. Of 402 patients, 194 (48%) had available EBV serology results at time of IBD diagnosis at a median of 12 years (IQR 9–14 years). Thereof, 102 (53%) were EBV-positive. Of 92 EBV-negative patients, 66 were retested and 17% showed a seroconversion at a mean follow-up time of 4.3 years (SD 3 years). Three children treated with azathioprine experienced acute clinically relevant EBV infection 2, 2.5, and 4 years after IBD diagnosis, two developed signs of hemophagocytic lymphohistiocytosis. Three cases of malignancy occurred in the cohort, though none seemed to be triggered by EBV. In conclusion, almost 50% of pediatric IBD patients were EBV-naïve following diagnosis and may be at increased risk to develop severe EBV infection during immunosuppressive therapy, potentially associated with complications such as hemophagocytic lymphohistiocytosis or malignancy.
format	article
author	Jennifer Bachmann Giang Le Thi Annecarin Brückner Anna-Lena Kalteis Tobias Schwerd Sibylle Koletzko Eberhard Lurz
author_facet	Jennifer Bachmann Giang Le Thi Annecarin Brückner Anna-Lena Kalteis Tobias Schwerd Sibylle Koletzko Eberhard Lurz
author_sort	Jennifer Bachmann
title	Epstein–Barr Virus Prevalence at Diagnosis and Seroconversion during Follow-Up in Pediatric Inflammatory Bowel Disease
title_short	Epstein–Barr Virus Prevalence at Diagnosis and Seroconversion during Follow-Up in Pediatric Inflammatory Bowel Disease
title_full	Epstein–Barr Virus Prevalence at Diagnosis and Seroconversion during Follow-Up in Pediatric Inflammatory Bowel Disease
title_fullStr	Epstein–Barr Virus Prevalence at Diagnosis and Seroconversion during Follow-Up in Pediatric Inflammatory Bowel Disease
title_full_unstemmed	Epstein–Barr Virus Prevalence at Diagnosis and Seroconversion during Follow-Up in Pediatric Inflammatory Bowel Disease
title_sort	epstein–barr virus prevalence at diagnosis and seroconversion during follow-up in pediatric inflammatory bowel disease
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3995d3fdb8bc4b9597c7a5026a30ec77
work_keys_str_mv	AT jenniferbachmann epsteinbarrvirusprevalenceatdiagnosisandseroconversionduringfollowupinpediatricinflammatoryboweldisease AT gianglethi epsteinbarrvirusprevalenceatdiagnosisandseroconversionduringfollowupinpediatricinflammatoryboweldisease AT annecarinbruckner epsteinbarrvirusprevalenceatdiagnosisandseroconversionduringfollowupinpediatricinflammatoryboweldisease AT annalenakalteis epsteinbarrvirusprevalenceatdiagnosisandseroconversionduringfollowupinpediatricinflammatoryboweldisease AT tobiasschwerd epsteinbarrvirusprevalenceatdiagnosisandseroconversionduringfollowupinpediatricinflammatoryboweldisease AT sibyllekoletzko epsteinbarrvirusprevalenceatdiagnosisandseroconversionduringfollowupinpediatricinflammatoryboweldisease AT eberhardlurz epsteinbarrvirusprevalenceatdiagnosisandseroconversionduringfollowupinpediatricinflammatoryboweldisease
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Epstein–Barr Virus Prevalence at Diagnosis and Seroconversion during Follow-Up in Pediatric Inflammatory Bowel Disease

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