title: A heart breaking case of rapidly developing severe hemophagocytic syndrome secondary to chronic active EBV infection; a case report and review of the literature.
abstract: Epstein-Barr virus (EBV, HHV-4) is a gamma Herpesvirus with a 90% >seroprevalence in adults. Reactivations in non-immuno compromised individuals usually cause mild or no symptoms at all. Rarely, host immunity-virus balance is interrupted, resulting in a chronic active EBV infection. The following case illustrates the rapid development of severe hemophagocytic syndrome during chronic active EBV infection in a 73 year old woman who presented with lower extremity pain and edema, splenomegaly and abnormal liver enzymes. A diagnosis of chronic active EBV infection was made following an extensive investigation and the patient died secondary to rapidly progressive hemophagocytic syndrome.
authors.affiliation: Department of Medicine, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem IL-91120, Israel. Electronic address: tawfikkhoury1@hotmail.com.
authors.forename: Khoury
authors.initials: K
authors.lastname: Tawfik
authors.affiliation: Department of Medicine, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem IL-91120, Israel. Electronic address: liron.yosha@gmail.com.
authors.forename: Yosha
authors.initials: Y
authors.lastname: Liron
authors.affiliation: Department of Medicine, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem IL-91120, Israel. Electronic address: aymansar@gmail.com.
authors.forename: Abu Rmieleh
authors.initials: AR
authors.lastname: Ayman
authors.affiliation: Department of Nephrology, Hadassah-Hebrew University Medical Center, P.O.B. 12000, Jerusalem IL-91120, Israel. Electronic address: ronensc@hadassah.org.il.
authors.forename: Ronen
authors.initials: R
authors.lastname: Schneider
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, P.O.B. 12000, Jerusalem IL-91120, Israel. Electronic address: danaw@emkd.huji.ac.il.
authors.forename: D G
authors.initials: DG
authors.lastname: Wolf
authors.affiliation: Department of Nephrology, Hadassah-Hebrew University Medical Center, P.O.B. 12000, Jerusalem IL-91120, Israel. Electronic address: RonenL@hadassah.org.il.
authors.forename: Levi
authors.initials: L
authors.lastname: Ronen
mesh_terms: D000368:Aged; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000473:pathology*
keywords: CAEBV infection; Hemophagocytic syndrome