Chronic Hepatitis and Hemophagocytic Lymphohistiocytosis Associated With Systemic Chronic Active Epstein-Barr Virus Disease.

IF 0.5 Q4 GASTROENTEROLOGY & HEPATOLOGY ACG Case Reports Journal Pub Date : 2025-03-20 eCollection Date: 2025-03-01 DOI:10.14309/crj.0000000000001649
Emmanuel Palomera-Tejeda, Lauren Shaffer, Michael Shi, Nagasri Shankar, Roshan Raza, George Cholankeril
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Abstract

Systemic chronic active Epstein-Barr virus (EBV) disease is a rare, delayed, and life-threatening complication of EBV infection. It is characterized by persistent viremia and a mononucleosis-like syndrome with multisystemic involvement because of lymphocytic tissue infiltration. We present the case of an 82-year-old woman without known immunodeficiency who presented with abnormal liver enzymes and interstitial pneumonia. Investigations revealed hyperferritinemia, elevated soluble interleukin-2 receptor levels, hypofibrinogenemia, and hepatosplenomegaly, consistent with hemophagocytic lymphohistiocytosis, as well as a high EBV viral load. Liver biopsy demonstrated portal chronic lymphocytic inflammation and positive EBV in situ hybridization, suggesting systemic chronic active Epstein-Barr virus disease as the underlying etiology.

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慢性慢性活动性爱泼斯坦-巴尔病毒病相关的慢性肝炎和噬血细胞淋巴组织细胞增多症。
系统性慢性活动性eb病毒(EBV)病是一种罕见的、延迟的、危及生命的EBV感染并发症。它的特点是持续性病毒血症和单核细胞增多症样综合征,由于淋巴细胞组织浸润而累及多系统。我们提出的情况下,82岁的妇女没有已知的免疫缺陷,谁提出了异常的肝酶和间质性肺炎。调查显示高铁蛋白血症,可溶性白细胞介素-2受体水平升高,低纤维蛋白原血症和肝脾肿大,与噬血细胞淋巴组织细胞增多症一致,以及高EBV病毒载量。肝活检显示门静脉慢性淋巴细胞炎症和EBV原位杂交阳性,提示系统性慢性活动性爱泼斯坦-巴尔病毒病是潜在的病因。
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来源期刊
ACG Case Reports Journal
ACG Case Reports Journal GASTROENTEROLOGY & HEPATOLOGY-
自引率
14.30%
发文量
170
审稿时长
12 weeks
期刊介绍: ACG Case Reports Journal is a peer-reviewed, open-access publication that provides GI and hepatology fellows, private practice clinicians, and other healthcare providers an opportunity to share interesting case reports with their peers and with leaders in the field. ACG Case Reports Journal publishes case reports, images, videos and letters to the editor in all topics of gastroenterology and hepatology, including: Biliary Colon Endoscopy Esophagus Functional Bowel Disorders Inflammatory Bowel Disease Liver Nutrition and Obesity Pancreas Pathology Pediatric Small Bowel Stomach.
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