title: A case of fatal infectious mononucleosis presenting with fulminant hepatic failure associated with an extensive CD8-positive lymphocyte infiltration in the liver.
abstract: We describe a fatal case of infectious mononucleosis presenting with fulminant hepatic failure associated with extensive CD8-positive lymphocyte infiltration and diffuse karyorrhexis in the liver. Immunohistochemical analysis of mononuclear cells showed that Leu-2a (CD8)-positive lymphocytes were heavily distributed in the portal areas and the sinusoidal spaces, but Leu-3a (CD4)-, Leu-14 (CD22)-, or My 4 (CD14)-positive cells were undetectable in sections of the liver. Southern blot hybridization studies disclosed the presence of Epstein-Barr virus DNA fragments in the liver tissue. The unusual pathologic and immunologic responses observed in this case could not simply be explained by severe Epstein-Barr virus infection. Some superimposed factors should be considered.
authors.affiliation: Department of Pediatrics, Akita University School of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Tazawa
authors.forename: F
authors.initials: F
authors.lastname: Nishinomiya
authors.forename: H
authors.initials: H
authors.lastname: Noguchi
authors.forename: G
authors.initials: G
authors.lastname: Takada
authors.forename: S
authors.initials: S
authors.lastname: Tsuchiya
authors.forename: R
authors.initials: R
authors.lastname: Sumazaki
authors.forename: H
authors.initials: H
authors.lastname: Takita
authors.forename: H
authors.initials: H
authors.lastname: Kanno
authors.forename: M
authors.initials: M
authors.lastname: Nose
authors.forename: T
authors.initials: T
authors.lastname: Konno
mesh_terms: D016827:CD8 Antigens; D017809:Fatal Outcome; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007223:Infant; D007244:Infectious Mononucleosis / Q000150:complications* / Q000473:pathology; D008099:Liver / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008213:Lymphocyte Activation; D008297:Male; D016176:T-Lymphocyte Subsets / Q000473:pathology*
chemical_list: D016827:CD8 Antigens