Suzuki Jun, Komada Takanori, Hirai Keiji, Tsuruoka Hirohisa, Mori Honami, Yoshida Izumi, Tabei Kaoru
Division of Nephrology, Saitama Medical Center, Jichi Medical University, Japan.
Intern Med. 2012;51(6):629-34. doi: 10.2169/internalmedicine.51.6299. Epub 2012 Mar 15.
Epstein-Barr virus (EBV) infection is common in adolescence, but fulminant infection is very rare. A 40-year-old man presented with high fever and sore throat. Symptoms, including cervical lymphadenopathy, jaundice, atypical lymphocytosis, respiratory distress and oliguria, suggested infectious mononucleosis with multiple organ failure that required mechanical ventilation and renal replacement therapy. Virus markers were consistent with primary EBV infection. Renal function was gradually improved by corticosteroid therapy. Renal biopsy revealed acute tubulointerstitial nephritis. In situ hybridizaion EBV-encoded RNA 1 did not show the presence of virus in the kidney, but acute kidney injury may be explained by cytotoxic/suppressor T lymphocyte infiltration.
爱泼斯坦-巴尔病毒（EBV）感染在青少年中很常见，但暴发性感染非常罕见。一名40岁男性出现高热和咽痛。症状包括颈部淋巴结病、黄疸、非典型淋巴细胞增多、呼吸窘迫和少尿，提示传染性单核细胞增多症伴多器官功能衰竭，需要机械通气和肾脏替代治疗。病毒标志物与原发性EBV感染一致。通过皮质类固醇治疗，肾功能逐渐改善。肾活检显示急性肾小管间质性肾炎。原位杂交EBV编码RNA 1未显示肾脏中存在病毒，但急性肾损伤可能由细胞毒性/抑制性T淋巴细胞浸润解释。
