A Case of Severe Chronic Active Epstein-Barr Virus Infection with Aplastic Anemia and Hepatitis
Epstein-Barr virus (EBV) causes various acute and chronic diseases. Chronic active EBV infection (CAEBV) is characterized by infectious mononucleosis-like symptoms that persist for more than 6 months with high viral loads in peripheral blood and/or an unusual pattern of anti-EBV antibodies. Severe C...
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| Format: | Article |
| Language: | English |
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Jin Publishing & Printing Co.
2016-01-01
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| Series: | The Korean Journal of Gastroenterology |
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| Online Access: | http://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2016.67.1.39 |
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| author | Ja In Lee Sung Won Lee Nam Ik Han Sang Mi Ro Yong-Sun Noh Jeong Won Jang Si Hyun Bae Jong Young Choi Seung Kew Yoon |
| author_facet | Ja In Lee Sung Won Lee Nam Ik Han Sang Mi Ro Yong-Sun Noh Jeong Won Jang Si Hyun Bae Jong Young Choi Seung Kew Yoon |
| author_sort | Ja In Lee |
| collection | DOAJ |
| description | Epstein-Barr virus (EBV) causes various acute and chronic diseases. Chronic active EBV infection (CAEBV) is characterized by infectious mononucleosis-like symptoms that persist for more than 6 months with high viral loads in peripheral blood and/or an unusual pattern of anti-EBV antibodies. Severe CAEBV is associated with poor prognosis with severe symptoms, an extremely high EBV-related antibody titer, and hematologic complications that often include hemophagocytic lymphohistiocytosis. However, CAEBV which led to the development of aplastic anemia (AA) has not been reported yet. A 73-year-old woman was admitted to our hospital with intermittent fever, general weakness and elevated liver enzymes. In the serologic test, EBV-related antibody titer was elevated, and real-time quantitative-PCR in peripheral blood showed viral loads exceeding 104 copies/µg DNA. Liver biopsy showed characteristic histopathological changes of EBV hepatitis and in situ hybridization with EBV-encoded RNA-1 was positive for EBV. Pancytopenia was detected in peripheral blood, and the bone marrow aspiration biopsy showed hypocellularity with replacement by adipocytes. AA progressed and the patient was treated with prednisolone but deceased 8 months after the diagnosis due to multiple organ failure and opportunistic infection. Herein, we report a rare case of severe CAEBV in an adult patient accompanied by AA and persistent hepatitis. (Korean J Gastroenterol 2016;67:39-43) |
| first_indexed | 2024-04-12T07:59:05Z |
| format | Article |
| id | doaj.art-ad9d5fe32bc34d10840424ebdea919fb |
| institution | Directory Open Access Journal |
| issn | 1598-9992 |
| language | English |
| last_indexed | 2024-04-12T07:59:05Z |
| publishDate | 2016-01-01 |
| publisher | Jin Publishing & Printing Co. |
| record_format | Article |
| series | The Korean Journal of Gastroenterology |
| spelling | doaj.art-ad9d5fe32bc34d10840424ebdea919fb2022-12-22T03:41:24ZengJin Publishing & Printing Co.The Korean Journal of Gastroenterology1598-99922016-01-01671394310.4166/kjg.2016.67.1.39kjg.2016.67.1.39A Case of Severe Chronic Active Epstein-Barr Virus Infection with Aplastic Anemia and HepatitisJa In Lee0Sung Won Lee1Nam Ik Han2Sang Mi Ro3Yong-Sun Noh4Jeong Won Jang5Si Hyun Bae6Jong Young Choi7Seung Kew Yoon8Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaEpstein-Barr virus (EBV) causes various acute and chronic diseases. Chronic active EBV infection (CAEBV) is characterized by infectious mononucleosis-like symptoms that persist for more than 6 months with high viral loads in peripheral blood and/or an unusual pattern of anti-EBV antibodies. Severe CAEBV is associated with poor prognosis with severe symptoms, an extremely high EBV-related antibody titer, and hematologic complications that often include hemophagocytic lymphohistiocytosis. However, CAEBV which led to the development of aplastic anemia (AA) has not been reported yet. A 73-year-old woman was admitted to our hospital with intermittent fever, general weakness and elevated liver enzymes. In the serologic test, EBV-related antibody titer was elevated, and real-time quantitative-PCR in peripheral blood showed viral loads exceeding 104 copies/µg DNA. Liver biopsy showed characteristic histopathological changes of EBV hepatitis and in situ hybridization with EBV-encoded RNA-1 was positive for EBV. Pancytopenia was detected in peripheral blood, and the bone marrow aspiration biopsy showed hypocellularity with replacement by adipocytes. AA progressed and the patient was treated with prednisolone but deceased 8 months after the diagnosis due to multiple organ failure and opportunistic infection. Herein, we report a rare case of severe CAEBV in an adult patient accompanied by AA and persistent hepatitis. (Korean J Gastroenterol 2016;67:39-43)http://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2016.67.1.39Epstein-Barr virus infectionsHuman herpesvirus 4HepatitisAplastic anemia |
| spellingShingle | Ja In Lee Sung Won Lee Nam Ik Han Sang Mi Ro Yong-Sun Noh Jeong Won Jang Si Hyun Bae Jong Young Choi Seung Kew Yoon A Case of Severe Chronic Active Epstein-Barr Virus Infection with Aplastic Anemia and Hepatitis The Korean Journal of Gastroenterology Epstein-Barr virus infections Human herpesvirus 4 Hepatitis Aplastic anemia |
| title | A Case of Severe Chronic Active Epstein-Barr Virus Infection with Aplastic Anemia and Hepatitis |
| title_full | A Case of Severe Chronic Active Epstein-Barr Virus Infection with Aplastic Anemia and Hepatitis |
| title_fullStr | A Case of Severe Chronic Active Epstein-Barr Virus Infection with Aplastic Anemia and Hepatitis |
| title_full_unstemmed | A Case of Severe Chronic Active Epstein-Barr Virus Infection with Aplastic Anemia and Hepatitis |
| title_short | A Case of Severe Chronic Active Epstein-Barr Virus Infection with Aplastic Anemia and Hepatitis |
| title_sort | case of severe chronic active epstein barr virus infection with aplastic anemia and hepatitis |
| topic | Epstein-Barr virus infections Human herpesvirus 4 Hepatitis Aplastic anemia |
| url | http://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2016.67.1.39 |
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