Letter to the Editor
Acute dacryocystitis retention syndrome due to Epstein-Barr virus
Síndrome de retención aguda lagrimal asociada a infección por virus de Epstein-Barr
V.M. Asensio-Sánchez
, F.J. Valentín-Bravo
Corresponding author
Servicio de Oftalmología, Hospital Clínico Universitario, Valladolid, Spain
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Asensio-Sánchez, F.J. Valentín-Bravo" "autores" => array:2 [ 0 => array:4 [ "nombre" => "V.M." "apellidos" => "Asensio-Sánchez" "email" => array:2 [ 0 => "vmasensio@yahoo.es" 1 => "victor_asensio@orangemail.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "F.J." "apellidos" => "Valentín-Bravo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Oftalmología, Hospital Clínico Universitario, Valladolid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de retención aguda lagrimal asociada a infección por virus de Epstein-Barr" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Infectious mononucleosis is usually caused by infection with the Epstein-Barr virus (EBV).<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> EBV is one of the most common viruses. Diagnosis is based on clinical suspicion with the classic triad of pharyngitis, fever and adenomegaly.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is confirmed by the presence of heterophilic ac and atypical lymphocytosis in peripheral blood. It is a self-limiting infection but sometimes presents with severe or atypical manifestations.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Marqués-Fernández et al.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> describe a previously unpublished case of acute lacrimal retention syndrome (ALR) associated with EBV infection, considering that ALR “was caused by inflammation and lymphoid hyperplasia of the nasal mucosa produced by EBV infection, in the inferior turbinate, where there is a dense lymphoid plexus that blocked Hassner’s valve”, “considering that the 7 publications described with EBV-associated dacryocystitis could be true ALR, which developed secondary acute dacryocystitis.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In a cytomorphological and immunophenotypic study, Paulsen et al.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> found lymphoid tissue in only 41% of the nasolacrimal ducts (NLD) examined, considering that the lymphoid tissue associated with NLD is a characteristic that is acquired throughout life, as in the case described by Marqués-Fernández et al.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Therefore, in the case described by Marqués-Fernández et al., at the age of 4 years, it is unlikely that a lymphatic network so important and dense as to produce ALR had developed in the NLD, so it would be more logical to think that the ALR was caused by dilatation-congestion of the luminal vascular plexus, which is comparable to a <span class="elsevierStyleItalic">corpus cavernosum</span>, connected to the <span class="elsevierStyleItalic">corpus cavernosum</span> of the inferior turbinate, regulating the diameter of the NLD. In addition, malfunction in the lacrimal corpus cavernosum and its innervation during EBV infection may lead to total occlusion of lacrimal flow. Therefore, the pathophysiology of ALR can be explained in this case: ascending inflammation of the nose initiates swelling of the mucous membrane, remodelling of the helical arrangement of the connective tissue fibres, malfunction in the subepithelial <span class="elsevierStyleItalic">corpus cavernosum</span> with reactive hyperemia and temporary occlusion of the lacrimal passage.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0010" class="elsevierStylePara elsevierViewall">No conflicts of interest were declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Asensio-Sánchez VM, Valentín-Bravo FJ. Síndrome de retención aguda lagrimal asociada a infección por virus de Epstein-Barr. Arch Soc Esp Oftalmol. 2022;97:358.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epstein-Barr virus infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.I. 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Galindo Ferreiro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oftale.2020.07.016" "Revista" => array:6 [ "tituloSerie" => "Arch Soc Esp Oftalmol" "fecha" => "2021" "volumen" => "96" "paginaInicial" => "321" "paginaFinal" => "325" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34092286" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mucosa-associated lymphoid tissue in human efferent tear ducts" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F.P. Paulsen" 1 => "J.I. Pauksen" 2 => "A.B. Thale" 3 => "B.N. Tillman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s004280000248" "Revista" => array:6 [ "tituloSerie" => "Virchows Arch" "fecha" => "2000" "volumen" => "437" "paginaInicial" => "185" "paginaFinal" => "189" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10993280" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009700000006/v1_202206060559/S2173579422000536/v1_202206060559/en/main.assets" "Apartado" => array:4 [ "identificador" => "5813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009700000006/v1_202206060559/S2173579422000536/v1_202206060559/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579422000536?idApp=UINPBA00004N" ]
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