A case of Autoimmune Hepatitis needed to be differentiated from EBV hepatitis, in that the histology of liver biopsy specimen was useful for diagnosis

Nakajima, Shoko; Umebayashi, Hiroaki; Kurosawa, Rumiko; Imagawa, Tomoyuki; Katakura, Shigeki; Mori, Masaaki; Aihara, Yasuo; Yokota, Shumpei; Sogo, Tuyoshi; Inui, Ayano; Fujisawa, Tomoo; Hanzawa, Naoto

doi:10.2177/jsci.28.154

Cited by 10 publications

(13 citation statements)

References 9 publications

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“…Those authors highlight that hepatic involvement of chronic active EBV infection should be included in the list of differential diagnoses, in cases of liver dysfunction with clinical and biochemical features of AIH [59]. In contrast is a case report by Nakajima et al [60] which describes the case of a ten-year-old female, admitted due to cholestasis and elevated liver enzymes for 2 months. EBV-DNA was found to be raised in the peripheral blood mononuclear cells [60].…”

Section: Ebv and Aihmentioning

confidence: 99%

Epstein-Barr Virus as a Trigger of Autoimmune Liver Diseases

Rigopoulou

Smyk

Matthews

et al. 2012

Advances in Virology

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The pathogenesis of autoimmune diseases includes a combination of genetic factors and environmental exposures including infectious agents. Infectious triggers are commonly indicated as being involved in the induction of autoimmune disease, with Epstein-Barr virus (EBV) being implicated in several autoimmune disorders. EBV is appealing in the pathogenesis of autoimmune disease, due to its high prevalence worldwide, its persistency throughout life in the host's B lymphocytes, and its ability to alter the host's immune response and to inhibit apoptosis. However, the evidence in support of EBV in the pathogenesis varies among diseases. Autoimmune liver diseases (AiLDs), including autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC), have a potential causative link with EBV. The data surrounding EBV and AiLD are scarce. The lack of evidence surrounding EBV in AiLD may also be reflective of the rarity of these conditions. EBV infection has also been linked to other autoimmune conditions, which are often found to be concomitant with AiLD. This paper will critically examine the literature surrounding the link between EBV infection and AiLD development. The current evidence is far from being conclusive of the theory of a link between EBV and AiLD.

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Section: Ebv and Aihmentioning

confidence: 99%

Epstein-Barr Virus as a Trigger of Autoimmune Liver Diseases

Rigopoulou

Smyk

Matthews

et al. 2012

Advances in Virology

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“…In contrast, Nakajima et al 15 reported a case of AIH with favourable outcome that needed to be differentiated from EBV hepatitis in which they stressed the importance of the histology of liver biopsy specimen “revealing interface hepatitis, dense mononuclear cell infiltrates, mild fibrosis, and negative for EBV in situ hybridization assay indicating AIH and not EBV-associated hepatitis”. To our knowledge this is the only previous case in the literature in which the favourable outcome of EBV associated AIH is reported.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune hepatitis following Epstein-Barr virus infection

Cabibi

2008

Case Reports

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We describe a case of a young man with autoimmune hepatitis (AIH) following Epstein-Barr virus (EBV) infection, in whom a long follow-up showed favourable outcome with complete clinical recovery and failure to relapse after cessation of immunosuppressive therapy. The study underlines the importance of the differential diagnosis between primary EBV associated hepatitis with features of autoimmunity, in which there is a direct pathogenetic role of the virus, and EBV related AIH, in which EBV could act as the trigger of the immune mediated damage with probable differences between the two conditions with regard to the prognosis and the responsiveness to immunosuppressive treatment. The favourable outcome in our patient, better than most of the AIH cases, may be related both to the moderate necroinflammatory activity and to the low level of fibrosis at the beginning of the disease, or to the role of EBV as a trigger of AIH. The hypothesis that EBV related AIH could have a more favourable prognosis than most of the AIH cases in general needs to be confirmed in a larger series of studies.

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“…On the contrary, Nakajima et al [15] reported a case of autoimmune hepatitis with favourable outcome that needed to be differentiated from EBV hepatitis in which they stressed the importance of the histology of liver biopsy specimen revealing interface hepatitis, dense mononuclear cell infiltrates, mild fibrosis, and negative for EBV in situ hybridization assay indicating AIH and not EBV-associated hepatitis.…”

Section: Discussionmentioning

confidence: 99%

Epstein - Barr virus Infection as a Trigger of Autoimmune Hepatitis: Case Report

Cabibi¹,

Scaduti²,

Cacciatore³

et al. 2008

American J. of Infectious Diseases

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Abstract:The study underlines the importance of the differential diagnosis between primary EpsteinBarr virus EBV associated hepatitis with features of autoimmunity, in which there is a direct pathogenetic role of the virus, and EBV related autoimmune hepatitis, in which EBV could act as the trigger of the immune-mediated damage with probable differences between the two conditions with regard to the prognosis and the responsiveness to immunosuppressive treatment. Moreover we hypothesise that the favourable outcome in our patient, better than the most of autoimmune hepatitis cases, may be related either to the moderate necroinflammatory activity and to the low level of fibrosis at the beginning of the disease or to the role of EBV as a trigger of autoimmune hepatitis. The hypothesis that EBV-related autoimmune hepatitis could have a more favourable prognosis than the most of autoimmune hepatitis cases in general need to be confirmed on a larger series of studies.

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A case of Autoimmune Hepatitis needed to be differentiated from EBV hepatitis, in that the histology of liver biopsy specimen was useful for diagnosis

Cited by 10 publications

References 9 publications

Epstein-Barr Virus as a Trigger of Autoimmune Liver Diseases

Epstein-Barr Virus as a Trigger of Autoimmune Liver Diseases

Autoimmune hepatitis following Epstein-Barr virus infection

Epstein - Barr virus Infection as a Trigger of Autoimmune Hepatitis: Case Report

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