The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

An Adult Case of Chronic Active Epstein-Barr Virus Infection with Interstitial Pneumonitis

  • Joo, Eun-Jeong (Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ha, Young-Eun (Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jung, Dong-Sik (Division of Infectious Diseases, Dong-A University Hospital) ;
  • Cheong, Hae-Suk (Division of Infectious Diseases, Konkuk University Medical Center) ;
  • Wi, Yu-Mi (Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Song, Jae-Hoon (Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Peck, Kyong-Ran (Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Published : 2011.12.01
⟨ Previous Next ⟩

Abstract

Chronic active Epstein-Barr virus (CAEBV) infection is characterized by persistent infectious mononucleosis-like symptoms, an unusual pattern of Epstein-Barr virus (EBV) antibodies, detection of the EBV genome in affected tissues or peripheral blood, and chronic illness that cannot be attributed to any other known disease. This is the first reported Korean case of an immunocompetent adult with CAEBV-associated interstitial pneumonitis. A 28-year-old female was admitted with a fever that persisted for 3 weeks. She had multiple lymphadenopathy, hepatosplenomegaly, pancytopenia, and elevated serum aminotransferase levels. Serology for antibodies was positive and chest computed tomography showed diffuse ground glass opacities in both lungs. Histopathology of the lung tissue showed lymphocyte infiltration, and EBV DNA was detected in those lymphocytes using in situ hybridization with an EBV-encoded RNA probe. After 1 month of hospitalization, she improved without specific treatment.

Keywords

References

  1. Cohen JI. Epstein-Barr virus infection. N Engl J Med 2000; 343:481-492. https://doi.org/10.1056/NEJM200008173430707
  2. Kimura H. Pathogenesis of chronic active Epstein-Barr virus infection: is this an infectious disease, lymphoproliferative disorder, or immunodeficiency? Rev Med Virol 2006;16:251-261. https://doi.org/10.1002/rmv.505
  3. Okano M, Kawa K, Kimura H, et al. Proposed guidelines for diagnosing chronic active Epstein-Barr virus infection. Am J Hematol 2005;80:64-69. https://doi.org/10.1002/ajh.20398
  4. Virelizier JL, Lenoir G, Griscelli C. Persistent Epstein-Barr virus infection in a child with hypergammaglobulinaemia and immunoblastic proliferation associated with a selective defect in immune interferon secretion. Lancet 1978;2:231-234.
  5. Joncas JH, Ghibu F, Blagdon M, Montplaisir S, Stefanescu I, Menezes J. A familial syndrome of susceptibility to chronic active Epstein-Barr virus infection. Can Med Assoc J 1984;130:280-284.
  6. Okano M, Sakiyama Y, Matsumoto S, Mizuno F, Osato T. Unusual lymphoproliferation associated with chronic active Epstein- Barr virus infection. AIDS Res 1986;2 Suppl 1:S121-S123.
  7. Straus SE. The chronic mononucleosis syndrome. J Infect Dis 1988;157:405-412. https://doi.org/10.1093/infdis/157.3.405
  8. Ankermann T, Claviez A, Wagner HJ, Krams M, Riedel F. Chronic interstitial lung disease with lung fibrosis in a girl: uncommon sequelae of Epstein-Barr virus infection. Pediatr Pulmonol 2003;35:234-238. https://doi.org/10.1002/ppul.10244
  9. Schooley RT, Carey RW, Miller G, et al. Chronic Epstein-Barr virus infection associated with fever and interstitial pneumonitis: clinical and serologic features and response to antiviral chemotherapy. Ann Intern Med 1986;104:636-643. https://doi.org/10.7326/0003-4819-104-5-636

Cited by

  1. An Adult Case of Severe Chronic Active Epstein-Barr Virus Infection with T-Cell Lymphoproliferative Disorder vol.27, pp.4, 2011, https://doi.org/10.3904/kjim.2012.27.4.474
  2. Detection of herpesvirus EBV DNA in the lower respiratory tract of ICU patients: a marker of infection of the lower respiratory tract? vol.202, pp.6, 2013, https://doi.org/10.1007/s00430-013-0306-1
  3. Interferon alpha as antiviral therapy in chronic active Epstein-Barr virus disease with interstitial pneumonia - case report vol.18, pp.None, 2011, https://doi.org/10.1186/s12879-018-3097-6
  4. Chronic active Epstein-Barr virus: a multidisciplinary approach vol.13, pp.12, 2011, https://doi.org/10.1136/bcr-2020-236287
  5. Acute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active Epstein-Barr virus infection: a case report vol.21, pp.1, 2011, https://doi.org/10.1186/s12879-021-06868-0