Epstein–Barr Virus-Induced Mononucleosis as an Imitator of Severe Preeclampsia

Background In pregnancy, conditions presenting with hematologic abnormalities, transaminitis, and proteinuria pose diagnostic challenges in pregnancy. Case We present the case of an 18-year-old woman, G1P0, at 33 weeks' gestation with fever of unknown cause, who developed progressively elevated liver enzymes, proteinuria, and thrombocytopenia, due to Epstein–Barr virus (EBV) infection. Conclusion Acute infection with EBV should be included in the differential diagnosis of preeclampsia with severe features, particularly in the setting of fever. Supportive treatment and observation may prevent iatrogenic preterm birth.

Download Full-text

Clinical and laboratory presentation of EBV positive infectious mononucleosis in young adults

Epidemiology and Infection ◽

10.1017/s0950268803008550 ◽

2003 ◽

Vol 131 (1) ◽

pp. 683-689 ◽

Cited By ~ 42

Author(s):

I. GROTTO ◽

D. MIMOUNI ◽

M. HUERTA ◽

M. MIMOUNI ◽

D. COHEN ◽

...

Keyword(s):

Young Adults ◽

Infectious Mononucleosis ◽

Epstein Barr Virus ◽

Liver Enzymes ◽

Barr Virus ◽

Ebv Infection ◽

Elevated Liver Enzymes ◽

Disease Pattern ◽

Epstein Barr ◽

Low Sensitivity

Clinical descriptions of Epstein–Barr virus (EBV) positive infectious mononucleosis (IM) are rare and their results are inconsistent. Over a 4-year period, we prospectively studied 590 young adults with clinically suspected IM, all of whom were tested for the presence of EBV IgM antibodies. We investigated the demographical, clinical and laboratory features of subjects with positive EBV IgM serology and heterophile antibodies. Contrary to previous studies, we found a seasonal disease pattern with a peak incidence during summer months, and a lower-than-expected prevalence of lymphadenopathy (88·9%), leucocytosis (46·2%), atypical lymphocytosis (89·2%) and elevated liver enzymes (57·9%). The prevalence of hyperbilirubinemia was relatively high (14·9%). The classic triad of fever, sore throat and lymph-adenopathy had relatively low sensitivity (68·2%) and specificity (41·9%) for EBV infection. Our study provides a complete and updated description of the clinical and laboratory presentation of laboratory confirmed IM, which is important for both clinicians and epidemiologists.

Download Full-text

Acute hepatitis due to infectious mononucleosis

BMJ Case Reports ◽

10.1136/bcr-2019-229679 ◽

2019 ◽

Vol 12 (8) ◽

pp. e229679

Author(s):

Robin G Manappallil ◽

Neena Mampilly ◽

Blessy Josphine

Keyword(s):

Acute Hepatitis ◽

Infectious Mononucleosis ◽

Epstein Barr Virus ◽

Liver Enzymes ◽

Barr Virus ◽

Ebv Infection ◽

Elevated Liver Enzymes ◽

Epstein Barr

The syndrome of infectious mononucleosis is commonly seen with Epstein-Barr virus (EBV) infection. It may cause acute hepatitis, which is usually self-limiting and characterised by mildly elevated liver enzymes, but rarely jaundice. The patient being reported showcases EBV infection with jaundice, which is an uncommon scenario.

Download Full-text

Epstein–Barr virus and regulatory T cells in Egyptian paediatric patients with acute B lymphoblastic leukaemia

Journal of Clinical Pathology ◽

10.1136/jclinpath-2016-203803 ◽

2016 ◽

Vol 70 (2) ◽

pp. 120-125 ◽

Cited By ~ 3

Author(s):

Mohamed E Ateyah ◽

Mona E Hashem ◽

Mohamed Abdelsalam

Keyword(s):

Lymphoblastic Leukaemia ◽

Epstein Barr Virus ◽

Acute Infection ◽

Treg Cells ◽

Control Group ◽

Healthy Children ◽

Barr Virus ◽

Ebv Infection ◽

High Incidence ◽

Epstein Barr

ObjectiveAcute B lymphoblastic leukaemia (B-ALL) is the most common type of childhood malignancy worldwide but little is known of its origin. Recently, many studies showed both a high incidence of Epstein–Barr virus (EBV) infection and high levels of CD4+CD25+Foxp3+(Treg cells) in children with B-ALL. In our study, we investigated the possible relationship between EBV infection and the onset of B-ALL, and its relation to expression of CD4+, CD25high+Foxp3+ T regulatory cells.Subject and methodsWe analysed expression and mean fluorescence intensity (MFI) of Treg cells in peripheral blood of 45 children with B-ALL and in 40 apparently healthy children as a control, using flow cytometry. Serum anti-EBV viral capsid antigen (VCA) IgG, anti-EBV nuclear antigen (EBNA) IgG (for latent infection) and anti-EBV VCA IgM (for acute infection) were investigated using ELISA.ResultsAnalysis of the Treg cells population in patients and controls revealed that expression of CD4+ CD25high+ T lymphocytes was higher in patients than in controls (mean±SD 15.7±4.1 and 10.61±2.6 in patients and controls, respectively, and MFI of Foxp3 was 30.1±7.1 and 16.7±3.7 in patients and controls, respectively (p<0.001)). There was a high incidence of latent EBV infection in patients (31%) compared with controls (10%) while the incidence of acute infection was 12% in patients and 0% in the control group. To study the role of latent EBV infection in the pathogenesis of acute B-ALL, OR was calculated (OR=4.06, coefficient index 1.2–13.6).ConclusionsThese findings suggest a possible role for Treg cells and EBV in the pathogenesis of B-ALL. Further studies are needed on the possible mechanisms of tumour genesis related to Treg cells and EBV in children with B-ALL.

Download Full-text

Acute hepatitis: a rare complication of Epstein-Barr virus (EBV) infection

The Journal of Infection in Developing Countries ◽

10.3855/jidc.871 ◽

2010 ◽

Vol 4 (10) ◽

pp. 668-673 ◽

Cited By ~ 9

Author(s):

Mehmet Uluğ ◽

Mustafa Kemal Çelen ◽

Celal Ayaz ◽

Mehmet Faruk Geyik ◽

Salih Hoşoğlu

Keyword(s):

Liver Function ◽

Acute Hepatitis ◽

Epstein Barr Virus ◽

Acute Infection ◽

Healthy Woman ◽

Liver Function Tests ◽

Barr Virus ◽

Ebv Infection ◽

Function Tests ◽

Epstein Barr

Infectious Mononucleosis (IM), a benign lymphoproliferative disease, is the best known clinical syndrome caused by Epstein-Barr Virus (EBV). It usually resolves over a period of weeks or months without sequelae but may occasionally be complicated by a wide variety of neurologic, hematologic, hepatic, respiratory, and psychological complications. In this report we describe a patient with acute hepatitis following EBV-IM in a previously healthy woman. A 26-year-old woman who presented with fever, generalized weakness, nausea, sore throat, yellowing of skin, and a generalized skin rash was admitted to our clinic. Tonsillar enlargement, pharyngeal erythema, palatal petechiae, lymphadenopathy, and jaundice were noted. Significant atypical lymphocytes ( > 10%) were seen on the peripheral blood smear. Liver function tests such as ALT: 303 U/L, AST: 172 U/L, ALP: 193 U/L and total bilirubin: 7.3 mg/dl were elevated. Serological tests for EBV infection were consistent with acute infection (EBV virus capsid antigen was reactive with IgM and IgG antibodies). The Monospot test was also positive. On the seventh day, liver function tests and bilirubin had risen to peak level and platelets were decreased. The patient was managed supportively and her critical condition improved and was finally stabilized. Although the prognosis for IM is very favorable, a variety of acute complications may occur.

Download Full-text

Autoimmune hepatitis following Epstein-Barr virus infection: a diagnostic dilemma

BMJ Case Reports ◽

10.1136/bcr-2019-229615 ◽

2019 ◽

Vol 12 (7) ◽

pp. e229615 ◽

Cited By ~ 4

Author(s):

Haoran Peng ◽

Tanna Lim ◽

Jae Nam ◽

Jin Lee

Keyword(s):

Autoimmune Hepatitis ◽

Epstein Barr Virus ◽

Case Reports ◽

Acute Infection ◽

Epstein Barr Virus Infection ◽

Diagnostic Dilemma ◽

Barr Virus ◽

Ebv Infection ◽

Epstein Barr ◽

Barr Virus Infection

Epstein-Barr virus (EBV) infections frequently affect the liver and cause hepatitis. EBV is a well-known trigger of certain autoimmune diseases. There are few case reports showing the evidence of autoimmune hepatitis (AIH) following EBV infection. However, the diagnosis of AIH is very challenging in the setting of an acute infection. Here, we demonstrate a case of AIH following EBV infection in a patient ultimately recovered after receiving treatment for AIH.

Download Full-text

Epstein-Barr virus-associated acute pancreatitis

BMJ Case Reports ◽

10.1136/bcr-2019-231744 ◽

2019 ◽

Vol 12 (11) ◽

pp. e231744 ◽

Cited By ~ 1

Author(s):

Muhammad Baraa Hammami ◽

Reem Aboushaar ◽

Ahmad Musmar ◽

Safa Hammami

Keyword(s):

Acute Pancreatitis ◽

Young Adults ◽

Abdominal Pain ◽

Epstein Barr Virus ◽

Liver Enzymes ◽

Moderate Severity ◽

Barr Virus ◽

Ebv Infection ◽

Children And Young Adults ◽

Epstein Barr

Epstein-Barr virus (EBV) infection is mostly subclinical and resolves spontaneously without complications. Gastroenterology involvement usually manifests as asymptomatic liver enzymes elevation. We report a new case of acute pancreatitis complicating EBV infection and review the literature. EBV-associated acute pancreatitis is rare, usually develops in the setting of clinically clear EBV infection, occurs mostly in children and young adults, has mild-to-moderate severity, and has excellent prognosis with conservative management. It should be suspected when patients with an EBV infection picture develop unexplained abdominal pain.

Download Full-text

Epstein–Barr virus infection in primary immunodeficiency

LymphoSign Journal ◽

10.14785/lymphosign-2018-0011 ◽

2018 ◽

Vol 5 (3) ◽

pp. 65-85 ◽

Cited By ~ 1

Author(s):

Adi Ovadia ◽

Ilan Dalal

Keyword(s):

Primary Immunodeficiency ◽

Epstein Barr Virus ◽

Current Knowledge ◽

Acute Infection ◽

Epstein Barr Virus Infection ◽

Barr Virus ◽

Ebv Infection ◽

Increased Risk ◽

Abnormal Response ◽

Epstein Barr

Primary immunodeficiency (PID) is a group of genetic disorders which affects immune cell development, differentiation, and function. The affected individuals are highly susceptible to infection by a diverse array of pathogens. Epstein–Barr virus (EBV) infection is ubiquitous in humans and usually involves an asymptomatic or self-limiting clinical course. In rare cases, EBV can cause not only an acute infection but also a severe exaggerated immune response and lymphoproliferative disease. Furthermore, EBV infection in patients with PID can lead to immune dysregulation and increased risk of malignancies, in addition to the severe course of the acute infection. Recognition of the different genetic defects and their effect on immunological pathways provide us with fundamental insights into the pathophysiology of EBV infection and associated disease, and may lead to developing better targeted therapies in the future. Here, we review all of PIDs with an abnormal response to EBV disease. Statement of novelty: Here we provide a review of the current knowledge of all PIDs reported to be associated with abnormal response to EBV infection and associated disease, such as hemophagocytic lymphohistiocytosis.

Download Full-text

Epstein-Barr Virus (EBV)-associated Haemophagocytic Syndrome

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2012.008 ◽

2012 ◽

Vol 4 (1) ◽

pp. e2012008 ◽

Cited By ~ 6

Author(s):

Lorenza Torti ◽

Luigi Maria Larocca ◽

Giuseppina Massini ◽

Luciana Teofili

Keyword(s):

Epstein Barr Virus ◽

Multiorgan Failure ◽

Acute Infection ◽

Haemophagocytic Syndrome ◽

Barr Virus ◽

Ebv Infection ◽

Life Threatening ◽

Life Threatening Complication ◽

Epstein Barr

We describe the case of a 17- year old female who developed fatal haemophagocytic syndrome (HPS) one month following acute infection caused by Epstein-Barr virus (EBV). Despite initiation of treatment and reduction of EBV load, laboratory signs of HPS as severe cytopenia, hypofibrinogenemia, hyperferritinemia and hypertriglyceridemia persisted, and the patient died of multiorgan failure. HPS is a rare, but life-threatening complication of EBV infection.

Download Full-text