Human herpesvirus 8 infection in patients with POEMS syndrome-associated multicentric Castleman's disease.

Abstract

The polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes (POEMS) syndrome is a rare multisystemic disorder associated with osteosclerotic myeloma and multicentric Castleman's disease (MCD). Human herpesvirus type 8 (HHV-8) DNA sequences have been detected in lymph nodes of about 40% of human immunodeficiency virus (HIV)-negative patients with MCD, and in bone marrow stromal cells of patients with multiple myeloma. Considering these data, we investigated the presence of HHV-8 in 18 patients with POEMS syndrome (9 with MCD), by nested polymerase chain reaction (N-PCR) to detect DNA sequenses in various cells and tissues obtained by biopsy or at autopsy (13 patients, of whom 7 had MCD), and by an immunofluorescence assay to detect anti-HHV-8 IgG antibodies in blood (18 patients, of whom 9 had MCD). Detection of HHV-8 DNA was performed using three different N-PCR, targeting nonoverlapping regions in open reading frame (ORF) 25 and ORF26. Seven of 13 (54%) POEMS patients had HHV-8 DNA sequences in their tissues, as assessed by all three N-PCR, and 9 of 18 (50%) had circulating anti-HHV-8 antibodies. HHV-8 was mainly detected in the subset of POEMS patients with MCD (6 of 7 [85%] for DNA sequences; 7 of 9 [78%] for antibodies). The percentage of positive N-PCR was higher in lymph nodes than in bone marrow samples (P <.02). Sequencing of amplicons showed a homogeneous restricted variability in the ORF26 region, characteristic of the minority subgroup B defined by Zong, and responsible for isoleucine and glycine substitutions at amino acid positions 134 and 167. These findings strongly suggest an association of HHV-8 infection with POEMS syndrome-associated MCD.

• Authors: L Bélec, A S Mohamed, F J Authier, M C Hallouin, A M Soe, S Cotigny, P Gaulard, R K Gherardi
• Journal: Blood (Blood) Vol. 93 Issue 11 Pg. 3643-53 (Jun 01 1999) ISSN: 0006-4971 [Print] United States
• PMID: 10339470 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Viral
• DNA, Viral

Topics

• Adult
• Aged
• Aged, 80 and over
• Amino Acid Sequence
• Antibodies, Viral (blood)
• Castleman Disease (blood, complications, virology)
• DNA, Viral (analysis)
• Female
• Herpesviridae Infections (blood, complications)
• Herpesvirus 8, Human (genetics, isolation & purification)
• Humans
• Male
• Middle Aged
• Molecular Sequence Data
• Open Reading Frames (genetics)
• POEMS Syndrome (blood, virology)
• Sequence Alignment