Severe hepatitis caused by Epstein-Barr virus without infection of hepatocytes.
Although hepatitis is a common feature of primary Epstein-Barr virus (EBV) infection, severe liver injury is rare and its pathogenesis is unclear. A previously healthy girl developed severe hepatitis with prolonged jaundice. Serologic examination showed that she had primary infection with EBV. An extremely high Epstein-Barr viral load was observed in her peripheral blood. The viral load decreased in parallel with symptomatic improvement. Histologic examinations showed spotty necrosis of the liver parenchyma and infiltration by CD8(+) T cells. The CD8(+) T cells, not hepatocytes, were positive for EBV. Possible mechanisms of viral hepatitis without infection of hepatocytes are discussed.
Kimura
H
H
Departments of Pediatrics, Clinical Pathology, and Health Science, Nagoya University School of Medicine; and the Laboratory of Viral Oncology, Aichi Cancer Research Institute, Nagoya, Japan.
Nagasaka
T
T
Hoshino
Y
Y
Hayashi
N
N
Tanaka
N
N
Xu
J L
JL
Kuzushima
K
K
Morishima
T
T
D000956:Antigens, Viral / Q000032:analysis; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000473:pathology* / Q000821:virology; D005260:Female; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000209:etiology / Q000473:pathology*; D022781:Hepatocytes / Q000473:pathology* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007124:Immunoenzyme Techniques; D017403:In Situ Hybridization; D007223:Infant; D008099:Liver / Q000473:pathology / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods; D012367:RNA, Viral / Q000032:analysis; D019562:Viral Load
D000956:Antigens, Viral; D004279:DNA, Viral; C099537:Epstein-Barr virus encoded RNA 1; D012367:RNA, Viral