Burkitt Lymphoma Virus

 

Burkitt-Lymphoma Virus 

Now known as Epstein - Barr Virus

P.K.Ghatak,MD.

Epstein-Barr Virus (EBV) was originally known as Burkitt Lymphoma Virus.     Dr. Denis P. Burkitt (from Ireland) a surgeon working in Uganda reported a highly aggressive Head and Neck lymphoma of children in 1958. He sent biopsy specimens to Dr. Epstein, a Pathologist in the UK. Dr. Epstein, a virologist from Ireland and Dr. Achlonga, a Pathologist with interest in electron microscopy originally from Trinidad, worked together and identified a virus in the biopsy tissue. They reported their finding in 1964 and named the virus, Burkitt lymphoma virus. This is the first virus identified as the cause of human malignancy – the first human oncogene. The virus is known today as Epstein-Barr virus - EBV in short.

This articles on EBV is the 3rd and last of a series virus after producing the primary illness, then enter a latent period. In certain circumstances, the virus is reactivated and produce different illnesses. The EBV infects B-lymphocytes and B-memory cells and remains dormant in these cells. EBV is known to produce a number of malignancies and other medical illnesses when it reactivates.

In a previous blog, many aspects of the EBV were discussed, this article is a supplement to - 

https://humihealth.blogspot.com/search?q=Epstein+Barr+virus.

EBV infects children and young adults worldwide. Saliva of the infected people contains EBV and kissing is the common mode of spread of EBV. Contaminated utensils, food and drinks are additional modes of spread. Blood transfusion, organ transplants and sexual activity also spread EBV.

Infectious Mononucleosis is the primary illness.

Incubation period is long, 4 to 6 weeks. The symptoms are that of a URI, but distinctive features of EB virus infection are enlarged and edematous tonsils. Posterior cervical lymph node enlargement in addition to enlarged circular and longitudinal chains of cervical nodes and occasionally intrathoracic and axillary lymph nodes enlargement. The spleen is enlarged and may rupture with minor trauma. Liver enlargement is also seen

Another distinguishing feature is salmon colored morbilliform eruptions on the trunk in about 10% of cases; those who do not have skin lesions will develop itchy but similar skin eruptions if they receive Ampicillin. Peripheral blood examination shows lymphocytosis and large atypical lymphocytes - resembling monocytes, and that was the basis of calling the illness as Infectious mononucleosis. IgM antibody appear early and persists for 6 weeks, the IgG antibody appears later and remains positive for the life of the patient.

Latent period:

The latency is divided into 3 stages.

In the 1^st stage of latency, the virus remains totally inactive, except in Burkitt lymphoma. The initial adenopathy progress to lymphoma in a short time.

In the 2^nd stage the virus is only partly active and interferes with nucleic acid synthesis of the host cells, this results in gene mutation and subsequently chromosome breakage and fusion of genes.

In the final 3^rd stage the EBV is fully active and produces a number of malignancy and illnesses as listed below.

Illness produced after the virus is reactivated:

A. Malignancy-

Evidence points directly to EBV.

1. Burkitt lymphoma.

2. Undifferentiated Nasopharyngeal carcinoma.

3. Hodgkin lymphoma and perhaps non-Hodgkin lymphoma.

4. Lymphomas - designate as 1. Diffuse Large. 2. B-cell. 3. Extranodal T/NK. 4. Plasmablastic.5. Primary diffuse.

5. Hairy cell leukemia.

Evidence of EBV is strong but question remains -

1. Epithelial cell cancer of stomach.

2. Epithelial cells cancers of Tonsils, Thymus, Breasts, Skin, Uterine cervix,

3. Lymphoepithelial cancer of salivary glands.

Questionable association with EBV -

1. Renal cell cancer

2. Thyroid gland

3. Urinary bladder.

4. Leiomyoma / Leiomyosarcoma.

B. Non-Malignant Diseases.

Autoimmune diseases like 1. Sjorgen's syndrome 2. Rheumatoid arthritis. 3. SLE, 4. Type 1 Diabetes mellitus. 5. Hashimoto thyroiditis. 6. Graves' disease. 7. Multiple Sclerosis. 8. Hairy Leukoplakia.

Chronic illness.

    1. Long COVID-19

2. Chronic Mononucleosis. Symptoms are fatigue, fever, lymph node enlargement, Hepatosplenomegaly, headaches, joint pain and muscle pain.

3. Parkinson's disease and Acute cerebellar ataxia.

4. Irritable Bowl syndrome.

5. Chronic fatigue syndrome.

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