An Adult Case of Chronic Active Epstein-Barr Virus Infection with Interstitial Pneumonitis

Abstract

Chronic active Epstein-Barr virus (CAEBV) infection is characterized by persistent infectious mononucleosis-like symptoms, an unusual pattern of Epstein-Barr virus (EBV) antibodies, detection of the EBV genome in affected tissues or peripheral blood, and chronic illness that cannot be attributed to any other known disease. This is the first reported Korean case of an immunocompetent adult with CAEBV-associated interstitial pneumonitis. A 28-year-old female was admitted with a fever that persisted for 3 weeks. She had multiple lymphadenopathy, hepatosplenomegaly, pancytopenia, and elevated serum aminotransferase levels. Serology for antibodies was positive and chest computed tomography showed diffuse ground glass opacities in both lungs. Histopathology of the lung tissue showed lymphocyte infiltration, and EBV DNA was detected in those lymphocytes using in situ hybridization with an EBV-encoded RNA probe. After 1 month of hospitalization, she improved without specific treatment.

An Adult Case of Severe Chronic Active Epstein-Barr Virus Infection with T-Cell Lymphoproliferative Disorder

“…In that case, TCRγ gene rearrangement exhibited a polyclonal pattern, unlike that observed in our case. That finding indicates that the case reported by Joo et al [4] was a case of CAEBV infection that had not progressed to monoclonal LPD. Typically, EBV-associated LPDs are derived from B-cell diseases, such as Hodgkin's lymphoma or Burkitt's lymphoma, and are a well-established phenomenon in patients with primary or secondary immunodeficiencies [2].…”

“…In Korea, Joo et al [4] recently reported a case of CAEBV infection with interstitial pneumonitis in a young woman. She recovered spontaneously and exhibited a good clinical course.…”

Uncontrolled reactivation of EBV infection in a 26-year-old woman

“…Rarer forms of CAEBV include: pancytopaenia, CNS involvement, intracranial calcifications, inflammation of the salivary glands, sinusitis, and oral mucosal ulcerations [9,10].…”

Interferon alpha as antiviral therapy in chronic active Epstein-Barr virus disease with interstitial pneumonia - case report

“…Interstitial pneumonia is a diffused chronic interstitial lung disease associated with inflammation and/or fibrosis of the alveolar walls [ 10 ]. Three pulmonary manifestations associated with EBV infection: hilar/mediastinal lymphadenopathy, pleural effusion, and IP have been described in literature [ 5 ]. EBV-associated IP may be triggered by drugs, occupational exposure, hypersensitivity reactions and infections; some cases are, however, idiopathic [ 11 ].…”