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Drs Purtilo and Johnson suggest that EBV infection in an immune deficient XX/XY chimeric host could have led to the fatal lymphohistiocytic proliferation in our patient, analogous, perhaps, to the XLP. They base their suggestion on the high incidence of XX/XY chimerism in marmosets, which are also susceptible to EBV-induced lymphoproliferative disease. While this possibility is intriguing, there is no anamnestic or laboratory indication of a previous immune deficiency or EBV infection in our patient. The titer of anti-EBV-VCA antibodies, tested twice in the initial phase of the disease, IgG 1:128 and IgA negative, did not indicate a recent EBV infection. Nevertheless, we gratefully accept the suggestion of Drs Purtilo and Johnson to probe for the virus in tissues with the new techniques mentioned in their letter.
Cividalli G. Fatal Lymphohistiocytic Proliferation Owing to Epstein-Barr Virus-Reply. JAMA. 1982;247(13):1811. doi:10.1001/jama.1982.03320380017016
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