Fulminant hepatitis due to Epstein-Barr virus infection

Papatheodoridis, George V.; Delladetsima, J.; Kavallierou, L.; Kapranos, Nikiforos; Tassopoulos, Nicolaos C.

doi:10.1016/s0168-8278(95)80015-8

Cited by 44 publications

(13 citation statements)

References 19 publications

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“…The incidence of disseminated HSV infection is rare and mainly occurs in neonates and immunocompromised individuals, such as patients undergoing renal transplantation or receiving anti-cancer drugs, and leukemia or lymphoma patients, in whom systemic involvement by HSV is the main manifestation and hepatic involvement a part of this process [29]. It has been recognized that children infected by a herpes virus commonly have abnormal liver function [30,31], which is consistent with our findings in this clinical trial. In this investigation, we found that the incidence of abnormal liver function ranged from 3.5% to 64.0%, depending on the type of virus infection.…”

Section: Discussionsupporting

confidence: 89%

Correlation between infection of herpes virus family and liver function parameters: a population-based cross-sectional study

Cui

Huang

Wang

et al. 2017

J Infect Dev Ctries

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Introduction: To evaluate the relationship between seropositivity to herpes virus family and liver function parameters in children from southwest China. Methodology: A 2-year cross-sectional retrospective study of 6,396 children aged 6 months to 12 years was performed. All participants underwent physical examination and liver function tests. Results: Of the children, 622 were positive for EBV, HSV, or CMV IgM, with dramatic changes in liver function parameters. Aspartate aminotransferase and alanine aminotransferase levels were negatively correlated with EBV-IgM and hepatocellular injuries in children < 3 years of age, whereas a positive correlation between lactate dehydrogenase (LDH) and EBV-IgM and hepatocellular injuries was documented in children < 1 year of age. In those < 1 year and 3-6 years of age, HSV-IgM seropositivity was positively correlated with indirect bilirubin and γ-glutamyl transferase. The percentage of children < 1 year of age with positive CMV-IgM was 72.8% (158/217), approximately five times higher than that in those 1-3 years. Sixty-three children were infected with two pathogens simultaneously. Abnormal levels of LDH were observed in 85.71% of children simultaneously infected with CMV and HSV, 77.78% for CMV and EBV, 83.33% for EBV and HSV, and irregular levels of AST were noted in 69.19% of children infected with CMV and HSV, 77.78% for CMV and EBV, and 83.33% for EBV and HSV. Conclusions: Seropositivity to herpes virus family was correlated with abnormal liver function parameters across years of age. Clinicians should aim to protect the liver function of children infected with herpes viruses.

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Section: Discussionsupporting

confidence: 89%

Correlation between infection of herpes virus family and liver function parameters: a population-based cross-sectional study

Cui

Huang

Wang

et al. 2017

J Infect Dev Ctries

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“…EBV hepatitis is an important cause of viral hepatitis. Fulminant hepatitis is rare but has been reported [1] . Severe hepatitis is rare, although it has been reported.…”

Section: Discussionmentioning

confidence: 99%

A case of acute infectious mononucleosis presenting with very high ferritin

Thoufeeq¹

2007

WJG

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was found to be in urinary retention at the same time for which he was catheterised. He was not started on any new medications and denied taking any over the counter medications. He said his urine was dark and sometimes had dysuria. He denied any gastro-intestinal symptoms.His past history included osteoarthritis, previous myocardial infarction in 1993, gastro-oesophageal reflux disease and laparoscopic herniorrhaphy, H i s m e d i c a t i o n s w e r e 7 5 m g a s p i r i n , 1 0 m g atorvastatin, 300 mg quinine sulphate, 20 mg omeprazole and 5 mg amlodipine once daily. He said he was allergic to codeine phosphate. He was living on his own and his wife had recently passed away. His alcohol intake was negligible. There was no family history of any clinical significance.On clinical examination he was noticed to be jaundiced, afebrile, haemodynamically stable. There were no stigmata of chronic liver disease. His abdomen was soft with mild tenderness elicited in the right hypochondrium. No organomegaly or masses were noted. Examinations of cardiovascular and respiratory systems were normal.His blood tests were as follows: Hb = 14.7 g/dL (13.5-16.9), WBC = 6.1 (4.5-13.0), platelets = 161 (150-400), MCV = 92 fL (84-99.0), neutrophils = 1.65 (2.0-7.5), lymphocytes = 3.97 (1.5-4.0). A blood film showed a moderate number of atypical lymphocytes.Ser um ferritin was high at 2438 μg/L (25-400). Haemochromatosis screen was negative. PT, APTT and fibrinogen were normal. Sodium was 135 mmol/L (135-145), potassium 4.2 mmol/L (3.5-5.3), urea 6.1 mmol/L (3-7) and creatinine 102 μmol/L (53-115) ( Table 1).B i l i r u b i n w a s 5 0 μ m o l / L ( 0 -2 0 ) , a l a n i n e aminotransferase (ALT) 254 U/L (0-37), alkaline phosphatase (ALP) 677 U/L (39-128), gamma glutamic transpeptidase(GT) 817, albumin 34 g/dL (35-52), calcium 2.18 mmol/L (2.1-2.6), C reactive protein (CRP) 21 mg/L (0-8), alfa-fetoprotein 3.5 (0-5.8), C3 and C4 (complements) were normal; IgM was 3.73 g/L (0.5-2).Blood and urine cultures were negative. Hepatitis A, B, C and CMV serology were negative. Anti Epstein Barr virus (EBV) capsid antigens IgG and IgM were detected, Anti EBV nuclear antigen IgG was also detected.A n t i n u c l e a r a n t i b o d y ( A N A ) w a s n e g a t i v e . A n t i n e u t r o p h i l c y t o p l a s m i c a n t i b o d y ( A N C A ) , antimitochondrial, smooth muscle, liver kidney microsomal antibodies were all negative.Chest and abdominal X-rays showed no radiological abnormalities.

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“…Generally, only a mild, subclinical elevation in transaminase levels occurs; however, there are a few case reports of fulminant hepatic failure associated with EBV (29)(30)(31). Histological, periportal lymphoid infiltrates are noted, without evidence of direct infection of the hepatic parenchymal cells (32).…”

Section: Discussionmentioning

confidence: 99%