scholarly journals EBV Infection Unmasking a Choledochal Cyst in an Infant

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Hassan El Khatib ◽  
Batoul Kawtharany ◽  
Diyaa Mohammad ◽  
Mohammad Siblini ◽  
Nahida El-Rifai
Keyword(s):  
Choledochal Cyst ◽  
Stone Formation ◽  
Liver Function Tests ◽  
Gamma Glutamyl Transferase ◽  
Barr Virus ◽  
Ebv Infection ◽  
Hepatic Involvement ◽  
Epstein Barr ◽  
Glutamyl Transferase

Hepatic involvement is common in acute Epstein–Barr virus (EBV) infection in children. It usually manifests as a transitory elevation of transaminases in up to 80% to 90% of patients, and they normalize by 2 to 6 weeks. A cholestatic pattern with elevated gamma-glutamyl transferase (γGT) and alkaline phosphatase (ALP) is common, in up to 60% in young adults. However, jaundice is very rare occurring in only 5% of pediatric patients. We report here an 8-month-old female with EBV infection who developed obstructive jaundice 2 weeks after the initial infection. Radiologic investigations were compatible with choledochal cyst type IVa complicated by stone formation in the common bile duct. In case of clinical exacerbation or nonamelioration of liver function tests in EVB infection, another diagnosis should be addressed. This highlights the importance of close follow-up in these patients in order not to miss a serious underlying condition such as choledochal malformation.

scholarly journals Gene EBNA3C: Type of Infection by EBV (EBV1 and EBV2) Correlation With Clinical and Biochemical Parameters (AST, ALT and GGT) in Individuals With Infectious Mononucleosis in the Metropolitan Area of Belém, Pará, 2005-2016

2019 ◽  
Author(s):  
Talita Antonia Furtado Monteiro ◽  
Iran Barros Costa ◽  
Igor Brasil Costa ◽  
Thais Letícia dos Santos Corrêa ◽  
Beatriz Monteiro Rodrigues Coelho ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Biochemical Parameters ◽  
Clinical Signs ◽  
Cervical Lymphadenopathy ◽  
Metropolitan Region ◽  
Gamma Glutamyl Transferase ◽  
Barr Virus ◽  
Significant Difference ◽  
Epstein Barr ◽  
Glutamyl Transferase

Abstract Background: Two types of Epstein Barr virus (EBV1 and 2) have been shown to infect humans. This study aimed to detect the types of EBV that cause infectious mononucleosis and correlate these viral types with clinical parameters in the metropolitan region of Belém from 2005 to 2016.Methods: A total of 76 cases of infectious mononucleosis (IM) were processed at the Instituto Evandro Chagas, Ananindeua, Brazil. PCR was used to analyze the EBNA 3C region for the recognition of EBV types. Biochemical testing (aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) was performed by the COBAS INTEGRA clinical biochemistry PLUS 400 / ROCHE automatic analyzer. The data were evaluated using the Statistical Package for Social Science - SPSS 17.0 and GraphPadPrism 7.0 for Windows.Results: EBV1 infection was observed in 71.1% (54/76) of individuals, among whom those > 14 years constituted 66.7% (36/54); the average age was 23 years, and the number of women infected was higher (61.1% [33/54]) than that of men 38.9%[21/54]). The symptoms/clinical signs observed in infection by EBV1 were cervical lymphadenopathy in 64.8% (35/54), fever in 63% (34/54), headache and arthralgia in 20.3% (11/54), and exanthema in 18.5% (10/54). Infection by EBV2 was observed in only 17.1% (13/76) of cases. Coinfections by EBV1 and EBV2, most frequently showing symptoms of fever and cervical lymphadenopathy, occurred in 66.7% (6/9) and 55.6% (5/9) of individuals. Alterations to AST were confirmed in 14.8% (8/54), EBV2 of cases in 7.7% (1/13) in EBV1 infection. Conclusions: EBV1 was predominant in 71% of clinical cases of infectious mononucleosis. The correlation of biochemical parameters in infection by EBV1, EBV2, and coinfections by EBV1/2 revealed a statistically significant difference in mean changes of EBV1 in individuals older than 14 years.

scholarly journals Epstein–Barr Virus Prevalence at Diagnosis and Seroconversion during Follow-Up in Pediatric Inflammatory Bowel Disease

2021 ◽  
Vol 10 (21) ◽  
pp. 5187
Author(s):  
Jennifer Bachmann ◽  
Giang Le Thi ◽  
Annecarin Brückner ◽  
Anna-Lena Kalteis ◽  
Tobias Schwerd ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Epstein Barr Virus ◽  
Barr Virus ◽  
Ebv Infection ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Epstein Barr

Primary Epstein–Barr virus infection in pediatric patients with inflammatory bowel disease during immunomodulation with thiopurines has been associated with increased risk for malignancies or hemophagocytic lymphohistiocytosis. We determined Epstein–Barr virus (EBV) seroprevalence at inflammatory bowel disease (IBD) diagnosis and seroconversion during follow-up in a large single center cohort of children with IBD. EBV serology results and patient characteristics were retrospectively retrieved from the hospital documentation system. EBV seronegative patients at IBD diagnosis were prospectively retested. We report on IBD patients with symptomatic active EBV infection and a complicated disease course, and those diagnosed with malignancy with respect to EBV status and drug exposure. Of 402 patients, 194 (48%) had available EBV serology results at time of IBD diagnosis at a median of 12 years (IQR 9–14 years). Thereof, 102 (53%) were EBV-positive. Of 92 EBV-negative patients, 66 were retested and 17% showed a seroconversion at a mean follow-up time of 4.3 years (SD 3 years). Three children treated with azathioprine experienced acute clinically relevant EBV infection 2, 2.5, and 4 years after IBD diagnosis, two developed signs of hemophagocytic lymphohistiocytosis. Three cases of malignancy occurred in the cohort, though none seemed to be triggered by EBV. In conclusion, almost 50% of pediatric IBD patients were EBV-naïve following diagnosis and may be at increased risk to develop severe EBV infection during immunosuppressive therapy, potentially associated with complications such as hemophagocytic lymphohistiocytosis or malignancy.

scholarly journals Gene EBNA3C: Type of Infection by EBV (EBV1 and EBV2) Correlation With Clinical and Biochemical Parameters (AST, ALT and GGT) in Individuals With Infectious Mononucleosis in the Metropolitan Area of Belém, Pará, 2005-2016

2019 ◽  
Author(s):  
Talita Antonia Furtado Monteiro ◽  
Iran Barros Costa ◽  
Igor Brasil Costa ◽  
Thais Letícia dos Santos Corrêa ◽  
Beatriz Monteiro Rodrigues Coelho ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Biochemical Parameters ◽  
Clinical Signs ◽  
Cervical Lymphadenopathy ◽  
Metropolitan Region ◽  
Gamma Glutamyl Transferase ◽  
Barr Virus ◽  
Significant Difference ◽  
Epstein Barr ◽  
Glutamyl Transferase

Abstract Background: Two types of Epstein Barr virus (EBV1 and 2) have been shown to infect humans. This study aimed to detect the types of EBV that cause infectious mononucleosis and correlate these viral types with clinical parameters in the metropolitan region of Belém from 2005 to 2016.Methods: A total of 76 cases of infectious mononucleosis (IM) were processed at the Instituto Evandro Chagas, Ananindeua, Brazil. PCR was used to analyze the EBNA 3C region for the recognition of EBV types. Biochemical testing (aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) was performed by the COBAS INTEGRA clinical biochemistry PLUS 400 / ROCHE automatic analyzer. The data were evaluated using the Statistical Package for Social Science - SPSS 17.0 and GraphPadPrism 7.0 for Windows.Results: EBV1 infection was observed in 71.1% (54/76) of individuals, among whom those > 14 years constituted 66.7% (36/54); the average age was 23 years, and the number of women infected was higher (61.1% [33/54]) than that of men 38.9%[21/54]). The symptoms/clinical signs observed in infection by EBV1 were cervical lymphadenopathy in 64.8% (35/54), fever in 63% (34/54), headache and arthralgia in 20.3% (11/54), and exanthema in 18.5% (10/54). Infection by EBV2 was observed in only 17.1% (13/76) of cases. Coinfections by EBV1 and EBV2, most frequently showing symptoms of fever and cervical lymphadenopathy, occurred in 66.7% (6/9) and 55.6% (5/9) of individuals. Alterations to AST were confirmed in 14.8% (8/54), EBV2 of cases in 7.7% (1/13) in EBV1 infection. Conclusions: EBV1 was predominant in 71% of clinical cases of infectious mononucleosis. The correlation of biochemical parameters in infection by EBV1, EBV2, and coinfections by EBV1/2 revealed a statistically significant difference in mean changes of EBV1 in individuals older than 14 years.

scholarly journals Sever hepatitis induced by Epstein-Barr virus: case series

2018 ◽  
Vol 31 (1) ◽  
pp. 44-46
Author(s):  
Mohammad Reza Hasanjani Roushan ◽  
Mostafa Javanian ◽  
Zahra Aliramaji ◽  
Soheil Ebrahimpour
Keyword(s):  
Epstein Barr Virus ◽  
Case Series ◽  
Liver Function Tests ◽  
Case Histories ◽  
Respiratory Complications ◽  
Serological Tests ◽  
Barr Virus ◽  
Ebv Infection ◽  
Epstein Barr ◽  
Current Report

AbstractEpstein-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.

Manifestation and prognostic value of EBV serology in nasal/nasopharyngeal T and NK-cell lymphomas

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7596-7596
Author(s):  
Y. Zhang ◽  
Y. Huang ◽  
J. Xiao ◽  
Y. Xia ◽  
T. Lu ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Nk Cell ◽  
Cell Lymphoma ◽  
Poor Prognostic Factor ◽  
Barr Virus ◽  
Ebv Infection ◽  
Kaplan Meier ◽  
Ann Arbor ◽  
Epstein Barr

7596 Background: Extranodal nasal type T and NK-cell lymphoma is highly associated with the Epstein-Barr virus (EBV) infection which is usually found in tumor cells, but the serum manifestation of EBV and its prognostic value remains unclear. Methods: 151 patients with nasal/nasopharyngeal T and NK-cell lymphomas were reviewed, the diagnoses of which were confirmed by histology and immunohistochemistry from Jan, 1992 to Nov, 2004. In 40 patients, which included 30 males and 10 females and aged 24 to 73(median 46) years old, analyses were performed of serum titers of antibodies against virus-capsid antigen (VCA-IgA) and early antigen (EA-IgA) with immunoenzyme assay, and antibody against EBV DNAase (EDAb), with immunoradiological method. Positive criteria were identified as VCA-IgA ≥ 1: 10, EA-IgA≥ 1: 10, and EDAb ≥ 30%. Clinically, 87.5% of the 40 patients were staged as Ann Arbor I and II diseases. Most patients underwent combined chemo and radiotherapy. Results: Median follow-up time for survived patients was 17(6–136) months. Median survival time for the overall patients were 12 months. Highest serum VCA-IgA, EA-IgA, and EDAb levels were 1: 1280, 1: 40, and 86% respectively. Positive rates of the three parameters were 60%, 15%, and 50% respectively. 30 patients(75%) had at least one positive parameter. Positve EA-IgA was negatively correlated with survival (p=0.0245) in Kaplan-Meier analysis, neither positive VCA-IgA or elevated EDAb level showed significant correlation with survival (p=0.134 and 0.405 ). Conclusions: Most patients with nasal/nasopharyngeal T and NK-cell lymphomas showed serum evidences of EBV infection, higher EA-IgA level can be a poor prognostic factor for survival. The importance of EBV serology in patients with nasal/nasopharyngeal T and NK-cell Lymphoma deserves further investigation. No significant financial relationships to disclose.

scholarly journals Epstein Barr virus genotypes (EBV1/EBV2) in individuals with infectious mononucleosis in the metropolitan area of Belém, Brazil, between 2005 and 2016

2020 ◽  
Author(s):  
Talita Antonia Furtado Monteiro ◽  
Talita Antonia Furtado Monteiro ◽  
Iran Barros Costa ◽  
Igor Brasil Costa ◽  
Thais Letícia dos Santos Corrêa ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Health Care Service ◽  
Clinical Signs ◽  
Cervical Lymphadenopathy ◽  
Metropolitan Region ◽  
Gamma Glutamyl Transferase ◽  
Barr Virus ◽  
Epstein Barr ◽  
Glutamyl Transferase

Abstract Background: Two types of Epstein Barr virus (EBV1/EBV2) have been shown to infect humans by causing infectious mononucleosis, their genome being very similar, except for regions of the EBNA genes. This study aimed to describe the EBV genotypes in cases of infectious mononucleosis in the metropolitan region of Belém, Brazil, from 2005 to 2016. Methods: A total of 8.295 suspected cases with symptoms/signs of infectious mononucleosis (MI) were investigated by doctors of infectious diseases at the Evandro Chagas Institute Health Care Service from January 2005 to December 2016. In 3.0% (251/8.295) of the cases were positive by enzymatic immunoassay were submitted to PCR for EBNA3C region to detect the types of EBV. Biochemical testing involving aspartate aminotransferase, alanine aminotransferase and gamma-glutamyl transferase were realized. Results: The identification of EBV types by PCR was verified in 30.3% (76/251) of individuals, being 71.1% (54/76) classified as EBV1, 17.1% (13/76) as EBV2 and 11.8% (9/76) as EBV1+EBV2. The number of women infected with EBV1 was higher (61.1% - 33/54) than for men (38.9% - 21/54), most were over 14 years old (66.7%-36/54). The main symptoms/clinical signs observed in EBV1 infection were: cervical lymphadenopathy (64.8%-35/54), fever (63%-34/54), headache (20.3%-11/54), arthralgia (20.3%-11/54) and exanthema (18.5%-10/54). In EBV2 infection, it was also detected in all age groups, with the exception of two groups, with an average age of 24 years. The presence of fever in 76.9% (10/13) with an average duration of 18 days and lymphadenopathy in 53.8 (7/13) were the most relevant signs/symptoms in EBV2. In contrast, EBV1+EBV2 co-infection was more frequent in the £5 year age group, affecting 20.0% (2/10). Women presented 66.7% (6/9) more positive cases. The symptoms involving EBV1+EBV2 co-infection were more related to fever (66.7%-6/9) and cervical lymphadenopathy (55.6% -5/9). The average of enzymatic values according to type of EBV was statistically significant (p <0.05) in individuals with EBV1 infection in those over 14 years of age. Conclusions: A pioneering study that molecularly identified the genotypes of EBV in 30.3% of cases, with circulation of EBV1, EBV2 and co-infection EBV1+EBV2 in cases of infectious mononucleosis in the northern region of Brazil.

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

2010 ◽  
Vol 4 (10) ◽  
pp. 668-673 ◽  
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.

scholarly journals Epstein-Barr Virus-induced Jaundice

2020 ◽  
Vol 4 (1) ◽  
pp. 69-71
Author(s):  
Jessica Herold ◽  
Felipe Grimaldo
Keyword(s):  
Biliary Obstruction ◽  
Epstein Barr Virus ◽  
Rare Complication ◽  
Liver Function Tests ◽  
Advanced Imaging ◽  
Barr Virus ◽  
Ebv Infection ◽  
Common Diagnosis ◽  
Epstein Barr ◽  
Made In

Infectious mononucleosis is primarily caused by Epstein-Barr virus (EBV) and is a common diagnosis made in emergency departments worldwide. Subclinical and transient transaminase elevations are a well-established sequela of EBV. However, acute cholestatic hepatitis is a rare complication. EBV infection should be considered as part of the differential diagnosis in patients with an obstructive pattern on liver function tests without evidence of biliary obstruction demonstrated on advanced imaging.

scholarly journals Limited Utility of Serology and Heterophile Test in the Early Diagnosis of Epstein–Barr Virus Mononucleosis in a Child after Renal Transplantation

Medicines ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. 21
Author(s):  
Alexandra Byrne ◽  
Rachel Bush ◽  
Felicia Johns ◽  
Kiran Upadhyay
Keyword(s):  
Early Diagnosis ◽  
Epstein Barr Virus ◽  
Antibody Test ◽  
Nuclear Antigen ◽  
Heterophile Antibody ◽  
Barr Virus ◽  
Ebv Infection ◽  
Limited Role ◽  
Epstein Barr

Background: Epstein–Barr virus (EBV) infection is associated with significant morbidity and mortality in renal transplant (RT) recipients. The spectrum of illness ranges from infectious mononucleosis (IM) to post-transplant lymphoproliferative disorder (PTLD). In association with clinical signs and symptoms, virus-specific serology and heterophile antibody tests are widely used in confirming the diagnosis of IM in the general population. However, these tests may have a limited role in immunosuppressed RT recipients from seropositive donor, especially in children who were EBV-seronegative prior to the transplant. The aim of this study is to evaluate the utility of these tests in the early diagnosis of IM in this subset of patients. Methods: This is a case study with a review of literature. Results: Here, we present a 14-year-old male with hemophilia B who presented with fever, fatigue, sore throat, palatal petechial rash, exudative tonsillitis and cervical lymphadenopathy 3 months post-RT. He was EBV seronegative prior to RT and received a deceased donor kidney transplant from a seropositive donor. Induction was done with Thymoglobulin and maintenance immunosuppression consisted of tacrolimus and mycophenolate. Initial heterophile antibody test (monospot) was negative, but became positive at 5 months and remained positive at 9 months follow-up post-RT. EBV viral capsid antigens (VCA) IgM and IgG, early antigen (EA) and nuclear antigen (EBNA) were all negative at the time of presentation. VCA IgM and IgG both became positive at 5 months and peaked at 9 months follow-up, however the EA and EBNA remained negative. EBV viral load as measured by polymerase chain reaction (PCR) was negative for the first 3 months post-RT but became positive at presentation, peaked at 6 months and started declining thereafter. Peripheral blood smear examination showed no absolute and atypical lymphocytosis. Cytomegalovirus PCR in the blood and throat culture for streptococcus were negative. There was no splenomegaly. He was managed conservatively with intravenous fluids, bed rest, antipyretics and reduction of immunosuppression. Conclusions: EBV serological markers have a limited role in the early diagnosis of EBV-IM following RT in prior seronegative children. Initial heterophile antibody test may also be negative, and hence a repeat test may be necessary. Once becoming positive, the VCA IgM may remain persistently elevated for prolonged duration. In addition to the suppressed cellular immunity secondary to immunosuppression, humoral response to viral infections is also delayed in transplant recipients, especially in the early transplant period. Hence, routine monitoring with PCR is superior to serology in diagnosing IM early and monitoring the EBV infection post-RT for timely evaluation and management.

scholarly journals P763 Epstein–Barr virus serological status in paediatric patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S607-S607
Author(s):  
S Feo-Ortega ◽  
G Pujol Muncunill ◽  
B Minguez-Rodríguez ◽  
L Álvarez-Carnero ◽  
L N Guevara-Caviedes ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Epstein Barr Virus ◽  
Seroconversion Rate ◽  
Immunosuppressive Treatment ◽  
Barr Virus ◽  
Ebv Infection ◽  
Serological Status ◽  
Inflammatory Bowel ◽  
Epstein Barr

Abstract Background The impact of Epstein–Barr virus (EBV) infection on the clinical outcomes of children and adolescents with inflammatory bowel disease (IBD) is not well known. The aim of the study is to evaluate the seroprevalence, seroconversion rate and complications associated with EBV infection in a cohort of paediatric IBD (PIBD) patients at a tertiary care hospital. Methods A descriptive study was performed collecting demographic, clinical and treatment data from medical records as well as EBV serological status of paediatric IBD patients from 2012 to 2018. In seronegative patients, seroconversion rate was evaluated. Complications associated with primary EBV infection were described. Since September 2016, EBV serology was included into the initial work-up for PIBD patients. For those patients who did not have EBV study at IBD onset, it was performed during follow-up. Results A total of 307 patients with PIBD were diagnosed between 2012 and 2018. EBV status was available for 131 patients (43%). Of those, 57% had Crohn’s Disease, 41% Ulcerative Colitis, and 2% IBD unclassified (66% males; median age at IBD diagnosis: 13.2 years (IQR: 0.8–17.8)). In 102 patients serological EBV status was determined at IBD onset; while in 17 patients it was performed during the follow-up. Overall, EBV seroprevalence was 67%, and no differences were observed regarding age (over or under 10 years-old). EBV seroprevalence was higher in females than in males (80% vs. 60.5%, p = 0.02). Regarding IBD treatment, 84% had received immunosuppressive treatment [thiopurines (32%), anti-TNF (9%) and combined treatment (59%)], without differences in the seroprevalence rate according to the treatment modality. Forty-three patients were seronegative, and 12 of them had a second determination during follow-up. Overall, 5 patients showed seroconversion (42%) after a mean follow-up of 24 months (IQR: 22–26). All these patients had received treatment with thiopurines: 2 patients presented symptomatic mononucleosis with neutropenia, requiring hospital admission and withdrawal of immunosuppressive treatment and 3 patients had asymptomatic primary infection. Conclusion EBV seroprevalence in our paediatric IBD cohort is similar as previously described in the literature. EBV status study in patients with IBD, especially prior to initiation of thiopurines, may be useful to plan subsequent follow-up since a non-negligible percentage of them could present with complicactions of primary EBV infection under immunosuppressive treatment.

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