Epstein-Barr virus associated with dermatopolymyositis: a case report

INTRODUCTION: The Epstein-Barr virus (EBV) is a DNA virus of the Herpesviridae family, which exists in the latent form in 95% of the world population. This virus infects the B lymphocytes, which promotes a persistent infection with periodic reactivations. EBV is probably a strong environmental factor in etiology of autoimmune diseases, once its viral proteins are involved in altering the host’s immune system, causing loss of self-tolerance and development of neoplasms. OBJECTIVE: To report a case of a patient with EBV associated with the development of dermatopolymyositis. CASE REPORT: Girl, 5 years, presenting erythematous-scaly lesions in extending region in upper and lower limbs. During follow-up, the patient’s mother returns referring worsening of the child, complaining of periodic fever, infection of upper airways and worsening of the lesions associated with difficulty of ambulation as well as difficulty of sitting in the past three weeks. Physical examination showed pharyngotonsillitis, cervical, axillary and inguinal adenomegalies and hepatomegaly. The limbs skin presented scaly and pruritic erythematous macules as well as on the metacarpophalangeal and interphalangeal joints, weakness of the pelvic muscles and arthralgia in the knees and ankles. After undergoing muscle biopsy, it presented a pattern for dermatopolymyositis, and imunosupression was initiated with methotrexate. Therefore, the patient improved clinically and laboratory regarding mononucleosis and the symptoms of dermatopolymyositis. The patient continues in specialized treatment and motor physiotherapy. CONCLUSION: Attention should be payed to the influence of viral component, such as the Epstein-Barr virus, on the pathogenesis of dermatopolymyositis in individuals genetically predisposed to autoimmune diseases.