Possible autoimmune hepatitis induced after chronic active Epstein−Barr virus infection
Tóm tắt
Chronic active Epstein−Barr virus infection (CAEBV) can be manifested in a variety of systemic conditions, including interstitial pneumonia, malignant lymphoma, and coronary aneurysm. Sometimes it may be associated with hepatic failure, although the mechanism underlying CAEBV-related hepatotoxicity remains unclear. We encountered a case of autoimmune hepatitis (AIH) associated with CAEBV. A 61-year-old male was referred to our hospital because of abnormal liver enzyme levels after initial diagnosis of CAEBV had been made by laboratory tests and liver biopsy. On admission, positivity for anti-nuclear antibody was evident, and examination of the liver biopsy specimen showed findings compatible with AIH. Steroid administration was initiated, and the liver function parameters subsequently improved. Although phenotypic changes in liver biopsy specimens are rare in this condition, the present case could provide clues to the possible pathogenesis of AIH.
Tài liệu tham khảo
Rickinson AB. Chronic, symptomatic Epstein–Barr virus-infections. Immunol Today. 1986;7:13–4.
Ohshima K, Suzumiya J, Sugihara M, et al. Clinicopathological study of severe chronic active Epstein–Barr virus infection that developed in association with lymphoproliferative disorder and/or hemophagocytic syndrome. Pathol Int. 1998;48:934–43.
Okano M, Matsumoto S, Osato T, et al. Severe chronic active Epstein–Barr-virus infection syndrome. Clin Microbiol Rev. 1991;4:129–35.
Kimura H, Morishima T, Kanegane H, et al. Prognostic factors for chronic active Epstein–Barr virus infection. J Infect Dis. 2003;187:527–33.
Kimura H, Hoshino Y, Kanegane H, et al. Clinical and virologic characteristics of chronic active Epstein–Barr virus infection. Blood. 2001;98:280–6.
Kimura H, Morita M, Yabuta Y, et al. Quantitative analysis of Epstein–Barr virus load by using a real-time PCR assay. J Clin Microbiol. 1999;37:132–6.
Alvarez E, Berg PA, Bianchi FB, et al. International autoimmune hepatitis group report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol. 1999;31:929–38.
Hennes EM, Zeniya M, Czaja AJ, et al. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology. 2008;48:169–76.
Krawitt EL. Medical progress: autoimmune hepatitis. N Engl J Med. 2006;354:54–66.
Vento S, Guella L, Mirandola F, et al. Epstein–Barr-virus as a trigger for autoimmune hepatitis in susceptible individuals. Lancet. 1995;346:608–9.
Vento S, Garofano T, Diperri G, et al. Identification of hepatitis-a virus as a trigger for autoimmune chronic hepatitis type-1 in susceptible individuals. Lancet. 1991;337:1183–7.
Huppertz HI, Treichel U, Gassel AM, et al. Autoimmune hepatitis following hepatitis-a virus-infection. J Hepatol. 1995;23:204–8.
Wucherpfennig KW. Mechanisms for the induction of autoimmunity by infectious agents. J Clin Invest. 2001;108:1097–104.
Okano M, Kawa K, Kimura H, et al. Proposed guidelines for diagnosing chronic active Epstein–Barr virus infection. Am J Hematol. 2005;80:64–9.