Clinical features of adult patients with chronic active Epstein-Barr virus infection
10.3760/cma.j.issn.0578-1426.2018.11.004
- VernacularTitle:成人慢性活动性EB病毒感染的临床特征分析
- Author:
Na XU
1
;
Hongwei FAN
;
Xiaoming HUANG
;
Yu WANG
;
Yue SHA
;
Yang JIAO
;
Weiguo ZHU
;
Yun ZHANG
;
Jialin CHEN
;
Xuejun ZENG
Author Information
1. 100730,中国医学科学院北京协和医学院北京协和医院普通内科
- Keywords:
Chronic active Epstein-Barr virus infection;
Adult;
Epstein-Barr virus
- From:
Chinese Journal of Internal Medicine
2018;57(11):811-815
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of adult-onset chronic active Epstein-Barr virus infection (CAEBV). Methods A total of 21 adult patients with CAEBV who were admitted to the department of General Internal Medicine at Peking Union Medical College Hospital from January 2006 to January 2016 were retrospectively analyzed. Demographic data, disease duration, clinical manifestations, laboratory findings, treatments and prognosis were reviewed. Results Eighteen females and 3 males were enrolled with a mean age of 39 years. The most common clinical manifestations included fever in 20 patients, splenomegaly in 20 patients, lymphadenopathy in 18 patients, and hepatomegaly in 10 patients, followed by laryngopharyngeal disorders in 6 patients, pleural effusion and peritoneal effusion each in 5 patients, rash in 4 patients, interstitial lung disease in 3 patients, gastrointestinal hemorrhage in 2 patients, and peripheral neuropathy and pulmonary hypertension each in 1 patient. Six patients were complicated with hemophagocytic lymphohis-tioncytosis(HLH) that developed 5-17 (mean: 9) months following CAEBV onset, all of whom experienced hyperpyrexia, pancytopenia, lymphadenopathy, splenomegaly, and liver dysfunction, 3 with hepatomegaly. Nineteen of the 21 patients had received steroid therapy including 10 combined with immunosuppressive agents, 11 with antiviral therapy, and 8 with intravenous immunoglobulin. Thirteen patients died, including 10 of multiple organ failure, (including 6 of HLH) 2 of severe pulmonary infection, and 1 of lymphoma. Six patients remained on follow-up, yet 2 were missing. Conclusions CAEBV is expected with severe condition and poor prognosis, which is likely to be complicated with HLH. Clinical physicians should pay attention to adult patients with fever, hepatosplenomegaly and lymphadenopathy, which suggests possible CAEBV.
