Cacopardo B, Nunnari G, Mughini M T, Tosto S, Benanti F, Nigro L
Department of Internal Medicine and Medical Specialities, Unit of Infectious Diseases, University of Catania, Italy.
Eur Rev Med Pharmacol Sci. 2003 Jul-Aug;7(4):107-9.
Fulminant hepatitis by Epstein-Barr virus is a rare event which is predominantly due to primary infection. We report a rare case of fatal hepatic failure due to Epstein-Barr virus reactivation in a 19-year-old boy who was taking oral steroids. Transaminase peak and the fulminant course of the disease began soon after steroid interruption. Epstein-Barr virus reactivation was diagnosed on the basis of past clinical history of heterophile-positive infectious mononucleosis, a high titer of IgG anti Epstein-Barr virocapsidic antigen, slight elevation of anti-virocapsidic IgM, a high titer of anti-EA IgG antibodies and elevated viral load in serum measured by polymerase chain reaction. It is concluded that Epstein-Barr virus should be considered as a possible etiological agent of fulminant hepatitis.
爱泼斯坦-巴尔病毒所致暴发性肝炎是一种罕见事件，主要由原发性感染引起。我们报告了一例罕见的因爱泼斯坦-巴尔病毒再激活导致肝衰竭死亡的病例，患者为一名正在服用口服类固醇的19岁男孩。在停用类固醇后不久，转氨酶达到峰值，且疾病呈暴发性发展。根据既往嗜异性抗体阳性传染性单核细胞增多症的临床病史、高滴度的IgG抗爱泼斯坦-巴尔病毒衣壳抗原、抗衣壳IgM轻度升高、高滴度的抗EA IgG抗体以及通过聚合酶链反应测得的血清中病毒载量升高，诊断为爱泼斯坦-巴尔病毒再激活。结论是，爱泼斯坦-巴尔病毒应被视为暴发性肝炎可能的病因。
