Severe chronic active Epstein-Barr virus infection associated with multiple necrotic lesions in the liver
| Autor: | Takeshi Tsuchihashi, Atsuko Takeuchi, Akitaka Shibuya, Keizou Sakurai, Takahide Nakazawa, Katsunori Saigenji, Masaaki Watanabe, Hiroyuki Mitomi |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Pathology
medicine.medical_specialty Hepatology Mononucleosis medicine.diagnostic_test Gene rearrangement Biology medicine.disease_cause medicine.disease Epstein–Barr virus Pathogenesis Infectious Diseases Chronic active EBV infection Coagulative necrosis hemic and lymphatic diseases Liver biopsy Immunology medicine Hemophagocytosis |
| Zdroj: | Hepatology research : the official journal of the Japan Society of Hepatology. 25(4) |
| ISSN: | 1386-6346 |
| Popis: | We report an atypical presentation of a chronic active Epstein-Barr virus (EBV) infection with multiple nodular coagulation necrosis in the liver, that appeared as hypodense areas on a CT scan. The patient, a 26-year-old man, was hospitalized following over 2 years of intermittent fever, weight loss and liver abnormalities after contracting infectious mononucleosis. We diagnosed his illness as a chronic active EBV infection (CAEBV) because of the high antibody titers against EBV and the histological evidence of organ disease with demonstration of EBV mRNA. A liver biopsy revealed EBV-infected T-cell infiltration with hemophagocytosis and marked hepatocytolytic necrosis. The patient developed multiple coagulation necrosis with well-defined borders surrounding T-cell aggregation in the liver 8 months later. He died of respiratory failure due to interstitial pneumonitis. The analysis of EBV-genome termini demonstrated a clonal proliferation of T-cells harboring EBV, but no T-cell antigen receptor (TCR) gene rearrangement was observed. We speculate that the pathogenesis of this disease was an atypical expression of organ damage as a result of an aberrant T-cell response to EBV infection. |
| Databáze: | OpenAIRE |
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