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Fallo hepático fulminante debido al virus de Epstein-Barr en trastornos de inmunodeficiencia

Diana Coman¹, Julian Hercun¹, Daniel Corsilli²

¹Liver Unit, Centre hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada.

Canadian liver journal

|February 23, 2026

Resumen

La hepatitis por el virus de Epstein-Barr (VEB) suele ser leve, pero puede ser mortal en casos raros, especialmente con inmunodeficiencias como la enfermedad linfoproliferativa ligada al cromosoma X. La atención multidisciplinaria rápida es crucial para la lesión hepática grave.

Área de la Ciencia:

Hepatología
Virología
Inmunología

Sus antecedentes:

El virus de Epstein-Barr (VEB) causa comúnmente hepatitis, que típicamente se autolimita.
Pueden ocurrir resultados graves o fatales, especialmente en personas inmunocomprometidas.

Objetivo del estudio:

Informar sobre dos casos distintos de hepatitis aguda por VEB.
Destacar las diversas presentaciones clínicas y los resultados de la hepatitis por VEB.

Principales métodos:

Se utilizó un enfoque de serie de casos en un solo centro.
Se analizaron datos clínicos y hallazgos post mortem.

Principales resultados:

Un paciente experimentó hepatitis fulminante, insuficiencia multiorgánica y desregulación inmunitaria, sucumbiendo finalmente a la enfermedad. El examen post mortem reveló enfermedad linfoproliferativa ligada al cromosoma X (XLP), una inmunodeficiencia primaria.
El segundo paciente presentó hepatitis, citopenias y hepatoesplenomegalia asociadas con viremia persistente por VEB, respondiendo bien al tratamiento que incluyó dexametasona y rituximab.

Conclusiones:

La lesión hepática grave asociada al VEB requiere un manejo rápido y multidisciplinario.
La XLP es un factor de riesgo crítico para la hepatitis grave por VEB y complicaciones relacionadas.

Palabras clave:

Virus de Epstein-Barr (VEB)Enfermedad linfoproliferativa ligada al cromosoma X (XLP)Hepatitis fulminante Linfohistiocitosis hemofagocítica (LHH)Inmunodeficiencia

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