A Case of Ulcerative Colitis Following Acute Hepatitis Induced by Epstein-Barr Virus Infection

Oh, Seung Hyun; You, Chan Ran; Kim, Yang Soo; Bae, Si Hyun; Choi, Jong Young; Yoon, Seung Kew; Choi, Sang Wook

doi:10.4166/kjg.2016.68.2.104

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…Hepatic manifestations, present within 80% of all cases of IM, include self-limited elevation of hepatocellular enzyme levels [3]. The aforementioned elevation is moderate, slightly higher than normal, but EBV causes acute hepatitis rarely [4]. Jaundice is certainly infrequent (5% of the cases) so it is not generally considered a presentation symptom [5].…”

Section: Introductionmentioning

confidence: 99%

Sever hepatitis induced by Epstein-Barr virus: case series

Roushan

Javanian

Aliramaji

et al. 2018

Current Issues in Pharmacy and Medical Sciences

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Epstein-Barr virus (EBV) is a causative agent of infectious mononucleosis syndrome. This infection often resolves over a period of several months without outcomes, but may occasionally be complicated by a great variety of neurologic, hepatic, hematologic and respiratory complications. In the current report, we present the case histories of three patients with acute hepatitis following EBV infection when previously healthy. The patients showed fever, nausea, weakness, as well as yellowing of the skin, and then in the course of examination, sore throat. They were managed supportively and their clinical condition improved. Liver function tests such as ALT, AST, ALP, were undertaken and bilirubin were elevated. The serological tests for EBV infection were consistent with the acute phase of infection. The monospot test was also positive. The patients were managed supportively, and their critical condition was improved.

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Section: Introductionmentioning

confidence: 99%

Sever hepatitis induced by Epstein-Barr virus: case series

Roushan

Javanian

Aliramaji

et al. 2018

Current Issues in Pharmacy and Medical Sciences

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A review on co-existent Epstein–Barr virus-induced complications in inflammatory bowel disease

Tang

et al. 2019

European Journal of Gastroenterology &Amp; Hepatology

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There have been growing reports regarding the presence of Epstein–Barr virus (EBV) in the intestine portions of patients suffering from ulcerative colitis and Crohn’s disease, collectively termed as inflammatory bowel disease (IBD). Indeed, the prevalence of EBV infection increases in IBD patients due to prolonged employment of immunosuppressive drugs including azathioprine and infliximab. In turn, coinfection with EBV increases the propensity of development of lymphoproliferative disorders in the gastrointestinal tract including Hodgkin lymphoma, non-Hodgkin lymphomas, and lymphoepithelioma-like cholangiocarcinoma. Therefore, it is recommended that IBD patients on prolonged immunomodulator therapy should be monitored for the presence of primary intestinal lymphoproliferative diseases. Moreover, coinfection of EBV complicates the clinical course of IBD by increasing the severity, chronicity, inducing refractoriness and increasing relapse incidences. Therefore, it is recommended that antiviral drugs should be added in the conventional IBD therapy in the suspected cases of EBV infection. Research has also revealed that EBV-induced colitis is very similar to IBD and there are chances of misdiagnosis of IBD in the presence of EBV colitis. The proper diagnosis of EBV infection along with its timely treatment is necessary to avoid the severe complications in patients of IBD. The present review discusses the role of EBV coinfection in increasing the clinical complications of IBD patients.

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Anti-Epstein–Barr virus antibodies in Beijing during 2013–2017: What we have found in the different patients

Cui

Yan

et al. 2018

PLoS ONE

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BackgroundEpstein–Barr virus (EBV) is associated with nasopharyngeal carcinoma (NPC) which is prevalent in South China, and its association with systemic lupus erythematosus (SLE) or other autoimmune diseases has not been studied in the mainland of China. The EBV serological tests have been performed on patients with various diseases or manifestations for years at our institution and their values need to be evaluated.MethodsFor routine medical purposes, anti-EB viral capsid antigen (VCA) IgG, IgA and IgM antibodies, anti-EBV diffuse early antigen (EA-D) IgA antibodies, and anti-EBV nuclear antigen-1(EBNA-1) IgG antibodies were tested with commercial enzyme-linked immunosorbent assay (ELISA) in patients visiting Peking Union Medical College Hospital between 2013 and 2017. The test results were analyzed in this retrospective study.ResultsThere were a total of 11122 serum samples available to be tested in the study. As indicators of past EBV infection, the prevalence of VCA-IgG/EBNA1-IgG were 66.6%/58.5%, 84.3%/78.8%, 92.9%/87.0% and 98.5%/95.4% in patients aged under 5 years, 6–10 years, 11–20 years and 21–30 years old, respectively, and these values maintained at this highest rate as age increased further. The prevalence of VCA-IgM, as a parameter of acute EBV infection, was 14.6%, 10.2%, 10.4%, 6.3% and 3.1% in patients aged under 5 years, 6–10 years,11–20 years, 21–30 years, 31–40 years old, respectively, and decreased to 2%~3% in older patients. Patients with elevated serum liver enzymes were more likely to have a higher prevalence of EA/D IgA antibody (P < 0.01) and young patients (≤30 years) with lymphadenopathy were more likely to have higher prevalence of VCA-IgM antibody (P < 0.01). The prevalence of VCA-IgA and EAD-IgA were 87.0% and 59.2% in NPC patients, respectively, and both were significantly higher (P < 0.001) than that in non-NPC patients. The prevalence of VCA-IgA was 45.4% and 25.6% in SLE patients and patients with other autoimmune diseases, respectively, which were significantly (P < 0.001) and mildly (P = 0.039) higher than their controls. In pediatric SLE patients between 6 and10 years old, the prevalence of VCA-IgG, VCA-IgA and EBNA1-IgG was 100%, 59.5% and 100%, respectively, all being significantly higher than the age (6-10y) related controls (P< 0.01). In the 705 cerebral spinal fluid (CSF) specimens, VCA-IgG, VCA-IgM, VCA-IgA and EAD-IgA were found to be positive in 12.1%, 0.15%, 0.25% and 0.25%, respectively. There were 157 paired specimens (CSF and serum were collected simultaneously) and VCA-IgG was identified as positive in 12.7% of the CSF and 100% of the serum specimens.ConclusionsAround 98% of Chinese patients were infected with EBV before 30 years of age and the highest rate of acute EBV infection were observed in patients under 5 years old. EBV infection was found to be associated with elevated serum liver enzymes, NPC and SLE. Acute anti-EBV antibody was valued for young patients with lymphadenopathy but limited value for CNS neuropathy.

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A Case of Ulcerative Colitis Following Acute Hepatitis Induced by Epstein-Barr Virus Infection

Cited by 3 publications

References 22 publications

Sever hepatitis induced by Epstein-Barr virus: case series

Sever hepatitis induced by Epstein-Barr virus: case series

A review on co-existent Epstein–Barr virus-induced complications in inflammatory bowel disease

Anti-Epstein–Barr virus antibodies in Beijing during 2013–2017: What we have found in the different patients

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