Role of Ebstein-Barr virus in children with tonsillar hypertrophy

Aim: The aim of this clinical prospective study is to evaluate the relationship between Epstein-Barr virüs (EBV) and asymmetric and symmetric tonsillar hypertrophy in children between 3-14 years old.Material and Method: Tonsil size of forty two children were evaluated a orophayrngeal inspection preoperatively.Tonsils were grouped according to Brodsky L scala classification (Grade 1-4).Childrens are separated into two groups including the ones that have grade 1-2 and grade 3-4 tonsil size, +1 difference between two tonsils was accepted as tonsillar asymmetry. Viral capsid antigen IgG (VCA IgG), viral capsid antigen IgM (VCA IgM), early antigen and EBV nuclear antigen (EBNA) levels were measured in serum preoperatively. EBV latent membrane protein-1 and EBNA-2 levels were determined with immunohistochemical studies after paraffin sectioning. Chi-square and Fisher’s exact tests were used to compare groups. The study was approved by the ethics commite (KA0992). Results: The 20 of the cases were boy and 22 were girl. The mean age was 7.12±2.07. There were no significant difference between groups, among age and gender distribution.Thirty-two children (76.2%) were sero-positive for VCA IgG. Among 62.5% of them, EBNA IgG was also positive. VCA IgG was significanlty higher in children with tonsillar hypertrophy grade 3-4 and EBNA was significantly higher in children with tonsillar hypertrophy grade 1-2. All tonsil spacements are evaluated as chronic tonsillit that shows lymphoid hyperplasia. 35.7% of EBV is found by immunohistochemical staining.This ratio is determined as 28.6% for latent membran protein-1 and 19% for EBNA.The relationship between EBV and degree of tonsillar hypertrophy was found to be statistically insignificant (p>0.05). Asymetric tonsillar hypertrophy were seen among 16.7% of the children.The relationship between EBV and asymetric tonsillar hypertrophy was also found to be statistically insignificant (p>0.05). Conclusions: We found statistical correlation between the grade of tonsillar hypertrophy and viral load in serum. This study points out the reservoir of EBV in tonsil tissue. (Turk Arch Ped 2013; 48: 30-4)