{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:03:24Z","timestamp":1789653804749,"version":"4.0.0"},"reference-count":19,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease characterized by multi\u2010organ damage, with genetic, environmental, and viral factors implicated in its pathogenesis. Herpesviruses such as Epstein\u2013Barr virus (EBV) and cytomegalovirus (CMV) are known to trigger or exacerbate SLE, potentially through mechanisms like molecular mimicry and immune dysregulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We report the case of a 10\u2010year\u2010old girl who presented with a malar rash following sun exposure, accompanied by fever and arthritis. Laboratory investigations revealed the presence of multiple autoantibodies and serological evidence of active co\u2010infection with both EBV and CMV. A diagnosis of SLE with mild activity was established. The patient received intravenous methylprednisolone, belimumab, and oral ganciclovir. This led to significant clinical improvement, including resolution of the facial rash and normalization of joint mobility. Follow\u2010up assessments showed near\u2010complete normalization of inflammatory markers and autoantibody titers. However, causality cannot be established from a single case, and proposed mechanisms remain hypotheses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case suggests that acute co\u2010infection with EBV and CMV may play a role in the pathogenesis of SLE, possibly via molecular mimicry and B\u2010cell activation. Therefore, routine screening for EBV and CMV in adolescent SLE patients may be warranted to advance etiological research and inform personalized treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcla.70330","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T08:35:56Z","timestamp":1786696556000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Systemic Lupus Erythematosus Complicated by Acute\n                    <scp>EBV<\/scp>\n                    and\n                    <scp>CMV<\/scp>\n                    Co\u2010infection"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6172-5545","authenticated-orcid":false,"given":"Anning","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Peking Union Medical College &amp; Chinese Academy of Medical Sciences; National Clinical Research Center for Immunologic Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"},{"name":"Department of Laboratory Medicine, the Eighth Affiliated Hospital Sun Yat\u2010Sen University  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7046-7881","authenticated-orcid":false,"given":"Gengchun","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Peking Union Medical College &amp; Chinese Academy of Medical Sciences; National Clinical Research Center for Immunologic Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"},{"name":"Department of Clinical Laboratory, Shenzhen Baoan Hospital The Second Affiliated Hospital of Shenzhen University  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziping","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Peking Union Medical College &amp; Chinese Academy of Medical Sciences; National Clinical Research Center for Immunologic Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"},{"name":"Shenzhen Maternity and Child Healthcare Hospital, Women and Children's Medical Center Southern Medical University  Shenzhen Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Peking Union Medical College &amp; Chinese Academy of Medical Sciences; National Clinical Research Center for Immunologic Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Peking Union Medical College &amp; Chinese Academy of Medical Sciences; National Clinical Research Center for Immunologic Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"},{"name":"Department of Clinical Laboratory Fuzhou University Affiliated Provincial Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Peking Union Medical College &amp; Chinese Academy of Medical Sciences; National Clinical Research Center for Immunologic Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"},{"name":"Department of Medical Laboratory The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University  Huaian Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6744-5547","authenticated-orcid":false,"given":"Chaojun","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Peking Union Medical College &amp; Chinese Academy of Medical Sciences; National Clinical Research Center for Immunologic Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8469-4737","authenticated-orcid":false,"given":"Shulan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Peking Union Medical College Hospital, Peking Union Medical College &amp; Chinese Academy of Medical Sciences; National Clinical Research Center for Immunologic Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e37045"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit321"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-024-01167-9"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard\u20102024\u2010225831"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000289"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms160817331"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.587380"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.53941\/hm.2025.100012"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-214819"},{"issue":"12","key":"e_1_2_10_11_1","first-page":"763","article-title":"Intravenous Immunoglobulin for Pediatric Neuropsychiatric Lupus Triggered by EBV Cerebral Infection","volume":"18","author":"Brogna C.","year":"2016","journal-title":"Israel Medical Association Journal"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-004-1704-9"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/cimb46080509"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-005-0063-6"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12969-024-01025-8"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.7754\/Clin.Lab.2023.230904"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1590\/1984-0462\/2022\/40\/2020291"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-015-1520-2"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-008-0142-2"},{"issue":"3","key":"e_1_2_10_20_1","first-page":"606","article-title":"SLE Complicated by Primary EBV Infection in a 2\u2010Year\u2010Old Child","volume":"23","author":"Kishi T.","year":"2013","journal-title":"Modern Rheumatology"}],"container-title":["Journal of Clinical Laboratory Analysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcla.70330","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcla.70330","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcla.70330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T13:16:41Z","timestamp":1789651001000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcla.70330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":19,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/jcla.70330"],"URL":"https:\/\/doi.org\/10.1002\/jcla.70330","archive":["Portico"],"relation":{},"ISSN":["0887-8013","1098-2825"],"issn-type":[{"value":"0887-8013","type":"print"},{"value":"1098-2825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]},"assertion":[{"value":"2025-12-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70330"}}