A case of chronic EBV infection-related submassive hepatic necrosis

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  • Higami Katsuya
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University School of Medicine Research Center for Hepatitis and Immnunology, Konodai Hospital, National Center for Global Health and Medicine
  • Ishii Koji
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University School of Medicine
  • Sawa Misato
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University School of Medicine
  • Shinohara Mie
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University School of Medicine
  • Watanabe Manabu
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University School of Medicine
  • Tamura Akira
    Division of General and Gastroenterological Surgery, Department of Surgery, Toho University School of Medicine
  • Nakajima Sanae
    Department of Surgical Pathology, Toho University School of Medicine
  • Shibuya Kazutoshi
    Department of Surgical Pathology, Toho University School of Medicine
  • Kuramochi Shigeru
    Department of Pathology, National Hospital Organization Tokyo Medical Center
  • Sumino Yasukiyo
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University School of Medicine

Bibliographic Information

Other Title
  • 慢性活動性ＥＢウイルス感染症関連の亜広範肝壊死の１例
  • 症例報告 慢性活動性EBウイルス感染症関連の亜広範肝壊死の1例
  • ショウレイ ホウコク マンセイ カツドウセイ EB ウイルス カンセンショウ カンレン ノ アコウハン カン エシ ノ 1レイ

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Abstract

In April 2008 a 65-year-old Japanese man with chronic renal failure was referred to our department with liver dysfunction of unknown origin. His liver dysfunction resolved with conservative treatment but its origin was unknown. In September 2008, he was admitted to our department because of exacerbation of liver dysfunction along with elevation of anti-EBV-VCA-IgG antibody. We found EBV-DNA in the blood by PCR and then performed laparoscopic liver biopsy. EBV-DNA was also detected in the liver by the ISH and PCR methods, and liver biopsy specimens revealed submassive hepatic necrosis. Therefore, we made a diagnosis of hepatitis related to chronic active EBV infection (CAEBV). His liver function was transiently improved by intravenous injection of Stronger Neo-minophargen C, but his serum transaminases fluctuated. In January 2009, he was readmitted because of ascites. Serum transaminases were normalized by treatment with vidarabine and predonisolone. However, he died of pneumonia caused by aspergillus and cytomegalovirus infection in March 2009. Detection of EBV-DNA in the liver and blood, and making a correct histopathological diagnosis, are thought to be essential when serum anti-EBV-IgG antibody is markedly elevated.<br>

Journal

  • Kanzo

    Kanzo 51 (12), 706-713, 2010

    The Japan Society of Hepatology

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