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Fatal hepatitis during Epstein-Barr virus reactivation
B Cacopardo1, G Nunnari, M T Mughini
1Department of Internal Medicine and Medical Specialities, Unit of Infectious Diseases, University of Catania, Italy.
European Review for Medical and Pharmacological Sciences
|April 8, 2004
Summary
Epstein-Barr virus reactivation can cause fatal hepatitis, even in young adults. This case highlights the risk of fulminant hepatic failure following steroid interruption in Epstein-Barr virus patients.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Fulminant hepatitis is a rare but severe liver condition.
- Epstein-Barr virus (EBV) is a common virus, typically causing infectious mononucleosis.
- Primary EBV infection is the usual cause of EBV-associated hepatitis.
Observation:
- A 19-year-old male experienced fatal hepatic failure.
- The patient was on oral steroids, and symptoms began after steroid cessation.
- EBV reactivation was suspected as the cause of the severe liver disease.
Findings:
- Diagnosis of EBV reactivation was confirmed through serological tests and PCR.
- High titers of IgG antibodies against EBV VCA and EA were noted.
- Elevated EBV viral load in serum indicated active replication.
Implications:
- EBV reactivation should be considered in cases of unexplained fulminant hepatitis.
- Steroid therapy management requires careful consideration in EBV-positive individuals.
- This case underscores the potential for EBV to cause severe liver injury beyond primary infection.