Investigation of EB virus and cytomegalovirus in rapidly progressive interstitial pneumonitis in polymyositis/dermatomyositis by in situ hybridization and polymerase chain reaction

Clin Immunol Immunopathol. 1995 Dec;77(3):298-306. doi: 10.1006/clin.1995.1156.


In polymyositis/dermatomyositis (PM/DM), a rapidly progressive interstitial pneumonitis (RPIP) which is a fatal complication of unknown etiology has received increasing attention. We have encountered 9 RPIP cases among 150 PM/DM cases in the past 10 years. To investigate the pathogenic role of viruses in RPIP, we examined lung specimens from patients with RPIP in PM/DM for the presence of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) using polymerase chain reaction (PCR) and in situ hybridization (ISH). We analyzed 21 specimens from RPIP in PM/DM (n = 9), collagen diseases (n = 6; 4 had interstitial lung disease), and controls (n = 6). EBV was frequently detected in RPIP (7/9 by PCR 3/9 by ISH), but was also detected in other collagen diseases of the lungs. In lung specimens from both patients with RPIP in PM/DM and those with collagen diseases, EBV was significantly detected (13/15 by PCR, 5/15 by ISH, P < 0.005) compared to controls (1/6 by PCR, 0/6 by ISH). CMV was detected by ISH in 2 RPIP patients but in none of he others, though by PCR CMV was detected equally in the three groups studied. These findings indicate that a direct involvement of EBV or CMV in RPIP of PM/DM is unlikely, although it is possible that an immune response to latent viruses or viral products in PM/DM may have a role in the pathogenesis of the RPIP.

MeSH terms

  • Adult
  • Aged
  • Base Sequence
  • Blotting, Southern / methods
  • Cytomegalovirus / genetics
  • Cytomegalovirus / isolation & purification*
  • DNA Primers / chemistry
  • DNA, Viral / analysis
  • DNA, Viral / isolation & purification
  • Dermatomyositis / complications
  • Female
  • Herpesviridae Infections / virology*
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • In Situ Hybridization
  • Lung / virology
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Myositis / complications*
  • Myositis / therapy
  • Pneumonia, Viral / virology*
  • Polymerase Chain Reaction
  • Polymyositis / complications


  • DNA Primers
  • DNA, Viral