Tropical Medicine Unit, University Hospital for Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany.
Infection. 2013 Apr;41(2):565-9. doi: 10.1007/s15010-012-0321-y. Epub 2012 Aug 28.
A 40-year-old Ghanaian woman presented with fever and exanthema. She had anemia, leukopenia, increased erythrocyte sedimentation rate (ESR), creatinin kinase, lactate dehydrogenase (LDH), and liver enzymes. She was diagnosed with schistosomiasis and was cured with praziquantel. During the following years, she developed polymyositis, chronic nephritis, and life-threatening perimyocarditis. High numbers of Epstein-Barr virus (EBV)-encoded RNA copies were demonstrated in CD8+ T-lymphocytes from endomyocardial biopsies. There was no evidence of any underlying immunosuppression or an EBV-related malignancy. Chronic active EBV infection was diagnosed, a clinical picture not described in an adult African previously. Interestingly, among all therapy attempts, only rituximab was effective at stabilizing the disease.
一位 40 岁的加纳妇女出现发热和出疹。她患有贫血、白细胞减少症、红细胞沉降率（ESR）、肌酸激酶、乳酸脱氢酶（LDH）和肝功能升高。她被诊断为血吸虫病，并接受了吡喹酮治疗。在随后的几年中，她发展为多发性肌炎、慢性肾炎和危及生命的心包心肌炎。在心内膜心肌活检的 CD8+ T 淋巴细胞中检测到大量 EBV 编码的 RNA 拷贝。没有证据表明存在任何潜在的免疫抑制或 EBV 相关恶性肿瘤。诊断为慢性活动性 EBV 感染，这是以前在成年非洲人中未描述过的临床表现。有趣的是，在所有治疗尝试中，只有利妥昔单抗有效稳定了病情。
