Monozygous twins with Epstein-Barr infection in the nasopharynx

The article describes a clinical case of monozygotic twins with hypertrophy of the organs of the lymphopharyngeal ring. The examination revealed IgG to the Epstein-Barr virus capsid antigen in both patients. One twin had Epstein-Barr virus DNA in the sample from the oropharynx. It was this child who had complaints typical of patients with adenoid vegetation, and he required surgical treatment (endoscopic shaver adenotomy and radio wave bilateral tonsillotomy). At the time of the initial examination and in the absence of complaints the second twin revealed no DNA of Epstein-Barr virus in the oropharynx. This patient was diagnosed with adenoids of 1-2 degree. Due to the complaints of the second twin that appeared during the following year of observation, with previously negative results on active Epstein-Barr virus markers served as the reason for a repeated specific laboratory examination. Epstein-Barr virus DNA was found in a sample from this child’s oropharynx. This case using the twin control method by partner enabled us to demonstrate the significance of Epstein-Barr virus in the pathogenesis and clinic manifestations of chronic diseases of the lympho-pharyngeal ring organs in children.

1. Smatti M.K., Al-Sadeq D.W., Ali N.H., Pintus G., Abou-Saleh H, Nasrallah G.K. Epstein-Barr Virus Epidemiology, Serology, and Genetic Variability of LMP-1 Oncogene Among Healthy Population: An Update. Front Oncol 2018; 8: 211. DOI: 10.3389/fonc.2018.00211

2. Simovanyan E.N., Denisenko VB, Grigoryan A.V., Kim M.A., Bovtalo L.F., Belugina L.V. Epstein-Barr viral infection in children: improving the program of diagnosis and treatment. Childhood infections 2016; 15 (1): 15-24. (in Russ.) DOI: 10.22627/2072-8107-2016-15-1-15-24

3. Savenkova M.S., Vashura L.V., Abdulaev A.K., Andzhel’ A.E., Balakireva G.M., Rumyanceva I.G., Kuznecova E.S. The importance of herpesvirus infections in children. Pediatriya 2016; 95(2): 134-141. (in Russ.)

4. Ponezheva ZH.B., Grishaeva A.A., Popova T.I. Clinical forms of Epstein-Barr viral infection. RMG 2019; 10: 36-41. (in Russ.) http://www.imj.ru/articles/infektsiya/Klinicheskie_formy_virusnoy_infekcii_Epshtey-naBarr/?print_page=Y#ixzz6Y2cFdMJB

5. Nacharov P.V., Dzhagacpanyan I.E. Results of clinical, immunological laboratory studies and analysis of the gas composition of exhaled air in patients with chronic tonsillitis. Klinicheskaya labora-tornaya diagnostika (Russian clinical laboratory diagnostics) 2015; 9: 51-52. (in Russ.)

6. Endo L.H., Vassallo J., Sakano E, Brousset P. Detection of Epstein-Barr virus and subsets of lymphoid cells in adenoid tissue of children under 2 years of age. Int J Pediatr Oto-rhinol 2002; 66(3): 223-226.

7. Endo L.H., Sakano E, Camargo L.A., Vassallo J. Detection of Epstein-Barr virus in childrens adenoids by in situ hybridization. Int Congress Series 2003; 1257: 157-160. DOI: 10.1016/S0531-5131(03)01160-9

8. Larina L.A. The state of the ENT organs and sound analyzer in twins. Rossijskaya otorinolaringologiya 2003; 1: 87-89. (in Russ)

9. Byars S., Stearns S., Boomsma J. Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood. JAMA Otolaryngol Head Neck Surg 2018; 144(7): 594-603. DOI: 10.1001/jamaoto.2018.0614