title: An adult case of fulminant Epstein-Barr virus infection with acute tubulointerstitial nephritis.
abstract: Epstein-Barr virus (EBV) infection is common in adolescence, but fulminant infection is very rare. A 40-year-old man presented with high fever and sore throat. Symptoms, including cervical lymphadenopathy, jaundice, atypical lymphocytosis, respiratory distress and oliguria, suggested infectious mononucleosis with multiple organ failure that required mechanical ventilation and renal replacement therapy. Virus markers were consistent with primary EBV infection. Renal function was gradually improved by corticosteroid therapy. Renal biopsy revealed acute tubulointerstitial nephritis. In situ hybridizaion EBV-encoded RNA 1 did not show the presence of virus in the kidney, but acute kidney injury may be explained by cytotoxic/suppressor T lymphocyte infiltration.
authors.affiliation: Division of Nephrology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Suzuki
authors.forename: Takanori
authors.initials: T
authors.lastname: Komada
authors.forename: Keiji
authors.initials: K
authors.lastname: Hirai
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Tsuruoka
authors.forename: Honami
authors.initials: H
authors.lastname: Mori
authors.forename: Izumi
authors.initials: I
authors.lastname: Yoshida
authors.forename: Kaoru
authors.initials: K
authors.lastname: Tabei
mesh_terms: D000208:Acute Disease; D000328:Adult; D001706:Biopsy; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications*; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D009395:Nephritis, Interstitial / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000473:pathology / Q000628:therapy; D011239:Prednisolone / Q000627:therapeutic use; D017582:Renal Replacement Therapy; D012121:Respiration, Artificial; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology
chemical_list: D011239:Prednisolone