medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2005, Number 3

<< Back

Ann Hepatol 2005; 4 (3)

Hepatic manifestations of Epstein-Barr viral infection

Méndez-Sánchez N, Aguilar-Domínguez C, Chávez-Tapia NC, Uribe M

Language: English
References: 21
Page: 205-209
PDF size: 61.44 Kb.


Text Extraction

Little information exists in the international scientific or medical literature about the hepatic manifestations and complications of Epstein-Barr virus (EBV). The aim of this study was to describe a series of patients with hepatic manifestations of EBV infection. Our sample population was a series of patients whose hepatic dysfunction was correlated with a documented EBV infection. Serum concentrations of IgG and IgM antibodies against the EBV viral capsid antigen (anti-EBV VCA IgG), EBV early antigen, and EBV nuclear antigen (EBV-EBNA), and heterophilic antibodies were determined. The expression of latent membrane protein (LMP 1) was also evaluated in each patient. RESULTS. The study included nine patients (six men, three women) with a mean age of 43.5 years. Five patients presented with recent clinical pictures suggestive of acute EBV infection. Five patients began with a cholestatic pattern. Two patients required liver biopsies. Those liver biopsies showed positive immunohistochemical staining for LPM 1. No fatalities were attributed to EBV infection. In conclusion, the bilirubin levels of patients with acute EBV infection differed from those reported in the medical literature. EBV infection should be considered in the differential diagnosis of patients with liver abnormalities or diverse hepatic manifestations, increased levels of aminotransferases, or a transitory cholestatic pattern with a favorable outcome.


REFERENCES

  1. Cohen JI. Epstein-Barr virus infection. N Engl J Med 2000; 343: 481-92.

  2. Schaller RJ, Counselman FL. Infectious mononucleosis in young children. Am J Emerg Med 1995; 13: 438-40.

  3. Hickey SM, Strasburger VC. What every pediatrician should know about infectious mononucleosis in adolescents. Pediatr Clin North Am 1997; 44: 1541-56.

  4. Devereaux CE, Bemiller T, Brann O. Ascites and severe hepatitis complicating Epstein-Barr infection. Am J Gastroenterol 1999; 94: 236-40.

  5. Mendez-Sanchez N, Uribe M. Infectious mononucleosis hepatitis: a case-report. Ann Hepatol 2004; 3: 75-76.

  6. Jimenez-Saenz M, Perez-Pozo JM, Leal-Luna A, Herrerias-Gutierrez JM. Lethal liver failure in an elderly patient with hepatitis B superinfected with Epstein-Barr virus. Eur J Gastroenterol Hepatol 2002; 14: 1283-4.

  7. Kimura H, Nagasaka T, Hoshino Y, et al. Severe hepatitis caused by Epstein-Barr virus without infection of hepatocytes. Hum Pathol 2001; 32: 757-62.

  8. Yuge A, Kinoshita E, Moriuchi M, Ohno Y, Haga H, Moriuchi H. Persistent hepatitis associated with chronic active Epstein-Barr virus infection. Pediatr Infect Dis J 2004; 23: 74-6.

  9. Nobili V, Comparcola D, Sartorelli MR, Devito R, Marcellini M. Autoimmune hepatitis type 1 after Epstein-Barr virus infection. Pediatr Infect Dis J 2003; 22: 387.

  10. Schuster VH, Muschen M. Epstein-Barr virus and the B cell: a secret romance. Trends Microbiol 2003; 11: 243-5.

  11. Rajwal S, Davison S, Wyatt J, McClean P. Primary Epstein-Barr virus hepatitis complicated by ascites with Epstein-Barr virus reactivation during primary cytomegalovirus infection. J Pediatr Gastroenterol Nutr 2003; 37: 87-90.

  12. Patel S, Zuckerman M, Smith M. Real-time quantitative PCR of Epstein-Barr virus BZLF1 DNA using the LightCycler. J Virol Methods 2003; 109: 227-33.

  13. Hinedi TB, Koff RS. Cholestatic hepatitis induced by Epstein-Barr virus infection in an adult. Dig Dis Sci 2003; 48: 539-41.

  14. Valentini P, Angelone DF, Miceli Sopo S, Ngalikpima CJ, Ranno O. Cholestatic jaundice in infectious mononucleosis. Minerva Pediatr 2000; 52: 303-6.

  15. Carbonero CMJ, Torronteras SR, Cintado BC. [Infectious mononucleosis: study on hospitalized children]. An Esp Pediatr 1999; 51: 664-6.

  16. Massei F, Palla G, Ughi C, Macchia P, Maggiore G. Cholestasis as a presenting feature of acute Epstein-Barr virus infection. Pediatr Infect Dis J 2001; 20: 721-2.

  17. Bernstein CN, Minuk GY. Infectious mononucleosis presenting with cholestatic liver disease. Ann Intern Med 1998; 128: 509.

  18. Mendez-Sanchez N, Chavez-Tapia NC, Espinoza B, Herrera-Gomar M, Zamora-Valdes D, Uribe M. Acute liver failure and the Molecular Adsorbents Recirculating System: early experience in a tertiary care hospital in Mexico City. Ann Hepatol 2004; 3: 164-6.

  19. Barlow G, Kilding R, Green ST. Epstein-Barr virus infection mimicking extrahepatic biliary obstruction. J R Soc Med 2000; 93: 316-8.

  20. Murray PG, Young LS. Epstein-Barr virus infection: basis of malignancy and potential for therapy. Expert Rev Mol Med 2001; 2001: 1-20.

  21. Fang CY, Chang YS, Chow KP, Yu JS, Chang HY. Construction and characterization of monoclonal antibodies specific to Epstein-Barr virus latent membrane protein 1. J Immunol Methods 2004; 287: 21-30.




2020     |     www.medigraphic.com