Pathophysiology

In EBV related illness, EBV infection of B lymphocytes results in immortalisation and generates a T cell response (the atypical lymphocytes) which controls EBV proliferation. In severe immunodeficiency following prolonged use of cyclosporin, oligoclonal EBV-related lymphoma may develop which usually regresses with reduction of immunosuppressive therapy but may evolve to a monoclonal and aggressive lymphoma e.g. after MUD stem cell transplant. In malarial Africa, EBV infection is associated with an aggressive lymphoma—Burkitt's lymphoma see p204.

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