Epstein-Barr virus-associated enteritis with multiple ulcers: The first autopsy case.

Area of Science:

• Gastroenterology
• Virology
• Pathology

Background:

• Epstein-Barr virus (EBV)-associated enteritis is an exceptionally rare condition.
• Its clinical and pathological characteristics remain poorly understood.

Observation:

• A case report of a 73-year-old male with EBV-associated enteritis presenting with abdominal pain and terminal ileum ulcers.
• Endoscopic findings revealed multiple ulcers, leading to severe serosanguinous bowel discharge and necessitating surgical intervention.
• The patient ultimately succumbed to uncontrolled hemorrhage despite extensive surgical resection.

Findings:

• Autopsy revealed multiple ileal ulcers, some with a cobblestone appearance.
• Histological analysis showed significant lymphocytic and plasma cell infiltration around the ulcers.
• EBV-encoded RNA in situ hybridization (EBER-ISH) confirmed the presence of EBV in inflammatory cells, while Cytomegalovirus was negative.
• No other gastrointestinal segments showed inflammation or EBV presence.

Implications:

• EBV-associated enteritis can manifest with severe, life-threatening hemorrhage from intestinal ulcers.
• This condition should be considered in the differential diagnosis of unexplained enteritis and gastrointestinal bleeding.
• Further research is needed to fully characterize EBV-associated enteritis and guide clinical management.