A case of fatal infectious mononucleosis presenting with fulminant hepatic failure associated with an extensive CD8-positive lymphocyte infiltration in the liver.
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.
Tazawa
Y
Y
Department of Pediatrics, Akita University School of Medicine, Japan.
Nishinomiya
F
F
Noguchi
H
H
Takada
G
G
Tsuchiya
S
S
Sumazaki
R
R
Takita
H
H
Kanno
H
H
Nose
M
M
Konno
T
T
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*
D016827:CD8 Antigens