The role of Epstein-Barr virus in the development of chronic recurrent cystitis

Ibishev Kh.S., Sinelnik E.A., Alkhashash A.M.S., Ibishev А.Kh.

1) Rostov State Medical University Urology Research Institute, Rostov-on-Don, Russia; 2) Rostov State Medical University, Rostov-on-Don, Russia; 3) Head of the pathology department of GBU RO OKB No. 2, Rostov-on-Don, Russia

Introduction. Chronic recurrent cystitis (CRC) remains a challenging problem in urology, despite significant advances in diagnosis and treatment. Traditionally, the disease was primarily associated with bacterial infection; however, in recent years, interest in the role of viral pathogens in its development and maintenance of recurrent course has grown.
Materials and Methods. This study includes the results of examinations of 11 patients diagnosed with chronic recurrent cystitis (CRC) associated with the Epstein-Barr virus (EBV). Laboratory and instrumental tests were used during the examination: general clinical, cytological, bacteriological, and urine tests, cystoscopy, biopsy, morphological and immunohistochemical examination of bladder biopsies, and bladder ultrasound.
Results. Urine cytological examination revealed lymphocytic infiltration in 100% of cases. In 72.7% of patients, urothelial cells demonstrated characteristic cytological changes: chromatin clearing and increased nuclear size. Cystoscopy revealed moderate vascular injection and areas of pale yellowish mucosa. Morphological examination of bladder mucosal biopsies revealed pronounced lymphoplasmacytic infiltration in all patients (100%). Immunohistochemical examination of mucosal biopsies identified EBV antigens with pronounced nuclear expression.
Conclusions. Epstein-Barr virus may be involved in the etiology of chronic renal cell cystitis, requiring a targeted and therapeutic approach. The identified cytological, endoscopic morphological, and immunohistochemical markers can serve as a basis for early diagnosis and optimization of treatment in patients with EBV-associated chronic renal cell cystitis.

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About the Authors

Corresponding author: Kh.S. Ibishev – Doctor of Medical Sciences, Professor; Deputy Director of the Urology Research Institute, Professor of the Department of Urology and Human Reproductive Health (with a course in pediatric urology-andrology) of the Federal State Budgetary Educational Institution of Higher Education Rostov State Medical University of the Ministry of Health of the Russian Federation, Rostov-on-Don, Russia; e-mail: ibishev22@mail.ru

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