The clinical characteristics of immunocompetent adults with chronic active Epstein-Barr virus associated enteritis
10.3760/cma.j.issn.0578-1426.2018.07.004
- VernacularTitle:非免疫缺陷个体慢性活动性EB病毒感染相关性肠炎临床特点分析
- Author:
Xuyang DONG
1
;
Ji LI
;
Yue LI
;
Dong WU
;
Yan ZHANG
;
Wei CAO
;
Weixun ZHOU
;
Hong YANG
;
Jiaming QIAN
Author Information
1. 100730,中国医学科学院北京协和医学院北京协和医院消化内科
- Keywords:
Enteritis;
Epstein-Barr virus infection;
Clinical features
- From:
Chinese Journal of Internal Medicine
2018;57(7):487-493
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical and pathological characteristics of chronic active Epstein-Barr virus associated enteritis(CAEAE). Methods The clinical data of 6 CAEAE patients in Peking Union Medical College Hospital were retrospectively analyzed from January 2010 to November 2017, including clinical manifestations, endoscopic, pathological features, medications and clinical outcome. Results The male∶female ratio was 4∶2 and the average age was 34 years old. All patients did not have personal and family history of immunodeficiency. The common symptoms consisted of fever (6/6), abdominal pain (6/6), hematochezia (6/6) and diarrhea (5/6). The most frequently affected sites were colorectum (5/6), followed by small intestine (3/6). Further serologic tests revealed a high load of serum Epstein-Barr virus (EBV) DNA. The main manifestations under endoscopy were multifocal or diffuse irregular ulcers. There was inflammation in the ulcer bases and surrounding areas, where EBV-encoded small RNA (EBER) was positive by in situ hybridization (6/6). The common complications were massive hemorrhage (3/6) and intestinal perforation (2/6). None of treatment agents including glucocorticoid, ganciclovir, foscarnet sodium and cytotoxic drugs was effective. All patients died within 0.5 to 13 months after diagnosis. Conclusions CAEAE in immunocompetent individuals is a rare disorder with poor prognosis. It is difficult to differentiate CAEAE from inflammatory bowel disease due to similar clinical and endoscopic manifestations.
