Korean J Med.  2008 Jun;74(6):658-662.

A case of concomitant epstein-barr virus-induced hepatitis on chronic autoimmune hepatitis

Affiliations
  • 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. yoonsk@catholic.ac.kr
  • 2Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

Autoimmune hepatitis (AIH), a rare cause of chronic liver disease in Korea, is a chronic, predominantly periportal hepatitis characterized by hypergammaglobulinemia, tissue autoantibodies, and responsiveness to immunosuppressive therapy. Here we report a rare case of Epstein-Barr virus (EBV) hepatitis in the presence of a previous diagnosis of AIH. A 25-year-old woman was admitted to the hospital with fever and myalgias. Laboratory data showed elevated aminotransferases, hypergammaglobulinemia, increased anti-nuclear antibody (ANA) titer, positive anti-smooth muscle antibody (ASMA) test, negative anti-mitochondrial antibody (AMA) test, and negative antibody against liver kidney microsome-1 (anti-LKM-1) test. Serologic viral markers of EBV indicated a recent EBV infection. Liver biopsy was performed to search for evidence of accompanying autoimmune liver disease. Liver biopsy findings were consistent with chronic active hepatitis. In-situ hybridization performed on the liver tissue confirmed the presence of EBV DNA. The patient has been treated with prednisolone and has shown subsequent improvement in clinical symptoms and liver function tests.

Keyword

Autoimmune hepatitis; Epstein-Barr virus (EBV); Acute hepatitis

MeSH Terms

Adult
Autoantibodies
Biomarkers
Biopsy
Chimera
DNA
Epstein-Barr Virus Infections
Female
Fever
Hepatitis
Hepatitis, Autoimmune
Hepatitis, Chronic
Herpesvirus 4, Human
Humans
Hypergammaglobulinemia
Kidney
Korea
Liver
Liver Diseases
Muscles
Prednisolone
Transaminases
Autoantibodies
DNA
Prednisolone
Transaminases
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