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Laparoscopic and Histopathologic Features of the Liver in Severe Chronic Active Epstein‐Barr Virus Infection Syndrome: A Case Report
Author(s) -
KOUNOURA Kiyoshi,
OMAGARI Katsuhisa,
IKUNO Nobuhiro,
MATSUO Isao,
KOMATSU Kohei,
EGAWA Ichiei,
TOKUNAGA Masaki,
IMANISHI Takeo,
MAKIYAMA Kazuya,
HARA Kohei
Publication year - 1995
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1995.tb00395.x
Subject(s) - medicine , virus , antibody , antigen , pathology , liver biopsy , cytotoxic t cell , virology , biopsy , immunology , biology , biochemistry , in vitro
A 40‐year‐old man was admitted to our hospital with persistent fever, generalized lymphadenopathy and hepatosplenoamegaly. Immunological examination demonstrated high titers of several anti‐Epstein‐Barr virus (EBV) antibodies, including anti‐viral capsid antigens 1gG‐antibody 1: 20, 480, anti‐early antigens‐DR IgG‐antibody 1: 5, 120, and reduced activity of EBV‐specific cytotoxic T lymphocytes. Laparoscopic features resembled those of chronic active viral hepatitis, including an uneven surface appearance and diffuse hepatic enlargement. Histopathological examination of a liver biopsy specimen showed inflammatory cell infiltration along sinusoidal surfaces (single file appearance) and enlarged portal areas with intralobular punched‐out necrosis. The diagnosis was confirmed by detecting the EB viral genome in serum. Despite treatments with natural alpha‐interferon, adenosine arabinocide and recombinant human interleukin‐2, the patient died of progressive hepatic failure.