Severe Epstein-Barr virus-associated hemophagocytic syndrome in six adult patients.
BACKGROUND
EBV associated hemophagocytic syndrome (HPS) is an aggressive and potentially life-threatening condition. So far, most EBV associated HPS has been characterized mainly in infants and children in Asian countries.


RESULTS
Here, we report six cases of EBV associated HPS occurring in previously healthy adults in a non-endemic area within a short period of 3 years. All patients presented with fever, hepatosplenomegaly and pancytopenia as well as disturbed liver function tests and coagulopathy. Half were diagnosed as having lymphoma. While EBV-specific serological assays were non-diagnostic in four of the six patients, the presence of EBV DNA in plasma allowed the diagnosis of EBV associated HPS in all patients.


CONCLUSIONS
EBV associated HPS may be more prevalent in non-Japanese adults than was previously considered. Screening for hemophagocytic syndrome, in adults as well as in children, should include real-time PCR for EBV.
Elazary
Anat Scheiman
AS
Department of Internal Medicine B, Hadassah Medical Center, Jerusalem, Israel. anatscheiman@yahoo.com
Wolf
Dana G
DG
Amir
Gail
G
Avni
Batia
B
Rund
Deborah
D
Yehuda
Dina Ben
DB
Sviri
Sigal
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006529:Hepatomegaly / Q000473:pathology; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008099:Liver / Q000503:physiopathology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology* / Q000473:pathology; D008223:Lymphoma / Q000473:pathology; D008297:Male; D010198:Pancytopenia / Q000473:pathology; D013163:Splenomegaly / Q000473:pathology
D000914:Antibodies, Viral; D004279:DNA, Viral