Infectious Mononucleosis Hepatitis in Young Adults: Two Case Reports
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Infectious mononucleosis due to Epstein-Barr virus (EBV) infection sometimes causes acute hepatitis, which is usually self-limiting with mildly elevated transaminases, but rarely with jaundice. Primary EBV infection in children is usually asymptomatic, but in a small number of healthy individuals, typically young adults, EBV infection results in a clinical syndrome of infectious mononucleosis with hepatitis, with typical symptoms of fever, pharyngitis, lymphadenopathy, and hepatosplenomegaly. EBV is rather uncommonly confirmed as an etiologic agent of acute hepatitis in adults. Here, we report two cases: the first case with acute hepatitis secondary to infectious mononucleosis and a second case, with acute hepatitis secondary to infectious mononucleosis concomitantly infected with hepatitis A. Both cases involved young adults presenting with fever, pharyngitis, lymphadenopathy, hepatosplenomegaly, and atypical lymphocytosis confirmed by serologic tests, liver biopsy and electron microscopic study.
Abstract
Infectious mononucleosis due to Epstein-Barr virus (EBV) infection sometimes causes acute hepatitis, which is usually self-limiting with mildly elevated transaminases, but rarely with jaundice. Primary EBV infection in children is usually asymptomatic, but in a small number of healthy individuals, typically young adults, EBV infection results in a clinical syndrome of infectious mononucleosis with hepatitis, with typical symptoms of fever, pharyngitis, lymphadenopathy, and hepatosplenomegaly. EBV is rather uncommonly confirmed as an etiologic agent of acute hepatitis in adults. Here, we report two cases: the first case with acute hepatitis secondary to infectious mononucleosis and a second case, with acute hepatitis secondary to infectious mononucleosis concomitantly infected with hepatitis A. Both cases involved young adults presenting with fever, pharyngitis, lymphadenopathy, hepatosplenomegaly, and atypical lymphocytosis confirmed by serologic tests, liver biopsy and electron microscopic study.
참고문헌 (23)
- Macsween KF, "Epstein-Barr virus-recent advances", Lancet Infect Dis, 3, pp.131~140 (2003)
- Rickinson AB, "Epstein-Barr virus. in: Virology. vol. 2. 4th ed", pp.2575~2627 (2001), Lippincott Williams and Wilkins
- Markin RS, "Manifestations of Epstein-Barr virus-associated disorders in liver", Liver, 14, pp.1~13 (1994)
- Markin RS, "Hepatitis in fatal infectious mononucleosis", Gastroenterology, 93, pp.1210~1217 (1987)
- Paloheimo JA, "A case on mononucleosis-like syndrome after blood transfusion from a donor with symptomatic mononucleosis", J Cardiovasc Surg, 6, pp.558~561 (1965)
- Cen H, "Epstein- Bar virus transmission the donor organs in solid organ trans- plantation: polymerase chain reaction and restriction fragment length polymorphism analysis of IR2, IR3 and IR4", J Virol, 65, pp.976~980 (1991)
- Curm NF, "Epstein Barr virus hepatitis: cases series and review", South Med J, 99, pp.544~547 (2006)
- Cohen JI, "Epstein-Barr virus infection", Engl J Med, 343, pp.481~492 (2000)
- Lawee D, "Mild infectious mononucleosis presenting with transient mixed liver disease", Can Fam Physician, 53, pp.1314~1316 (2007)
- Adams LA, "Ganciclovir and the treatment of Epstein-Barr virus hepatitis", J Gastroenterol Hepatol, 21, pp.1758~1760 (2006)
- Karagoz G, "The coexistence of hepatitis A and infectious mononucleosis", Turk J Gastroenterol, 16, pp.102~104 (2005)
- Nelson RS, "Infectious mononucleosis hepatitis: a clinicopathologic study", Am J Med, 21, pp.26~33 (1956)
- Feranchak AP, "Fulminant Epstein-Barr viral hepatitis: orthotopic liver transplantation and review of the literature", Liver Transpl Surg, 4, pp.469~476 (1998)
- Kimura H, "Severe hepatitis caused by Epstein-Barr virus without infection of hepatocytes", Hum Pathol, 32, pp.757~762 (2001)
- Hinedi TB, "Cholestatic Hepatitis Induced by Epstein- Barr virus infection in an adult", Dig Dis Sci, 48, pp.539~541 (2003)
- Hara S, "Association of virus infected-T cell in severe hepatitis caused by primary Epstein-Barr virus infection", J Clin Virol, 35, pp.250~256 (2006)
- Mehal WZ, "Selective retention of activated CD8+ T cells by the normal liver", J Immunol, 163, pp.3202~3210 (1999)
- Kusters S, "Interferon gamma plays critical role in T cell-dependent liver injury in mice initiated by concanavalin A", Gastroenterology, 111, pp.462~471 (1996)
- Bradham CA, "Mechanisms of hepatic toxicity. I. TNF-induced liver injury", Am J Physiol, 275, pp.G387~G392 (1998)
- Kondo T, "Essential roles of the Fas ligand in the development of hepatitis", Nat Med, 3, pp.409~413 (1997)
- Ebell MH, "Epstein-Barr virus infectious mononucleosis", Am Fam Physician, 70, pp.1279~1290 (2004)
- Fleisher GR, "Limitations of available tests for diagnosis of infectious mononucleosis", J Clin Microbiol, 17, pp.619~624 (1983)
- Hart GK, "Fulminant hepatic failure and fatal encephalopathy associated with Epstein- Barr virus infection", Med J Aust, 141, pp.112~113 (1984)