Chronic active Epstein-Barr virus (CAEBV) infection is a systemic Epstein-Barr virus (EBV) positive lymphoprolifetative disease characterized by fever, lymphadenopathy, splenomegaly, unusual pattern of anti- EBV antibodies, and/or increased EBV genomes in affected tissues. Most cases are from Asia. So far, there is hardly any adult case reported from mainland of China. We herein presented a 33-year-old man with fever, facial erythema and rash, lymphadenopathy, lower limbs weakness, splenomegaly and liver lesion. EBV VCA, EA and EBNA were all positive. EBV DNA could be found in serum and PBMC. In situ hybridization of EBV encoded RNA in skin and liver biopsy was positive. Viral load in serum decreased under interferon alpha therapy. To our knowledge, it’s the first adult case reported from mainland of China.
1 Luzuriaga K, Sullivan JL. Infectious mononucleosis. N Engl J Med 2010;362:1993-2000.
2 Okano M, Kawa K, Kimura H, Yachie A, Wakiguchi H, Maeda A, et al. Proposed guidelines for diagnosing chronic active Epstein-Barr virus infection. Am J Hematol 2005;80:64-69.
3 Wang Q, Liu H, Zhang X, Liu Q, Xin Y, Zhou X, et al. High doses of mother’s lymphocyte infusion to treat EBV-positive T-cell lymphoproliferative disorders in childhood. Blood 2010;116:5941-5947.
4 Cohen JI, Jaffe ES, Dale JK, Pittaluga S, Heslop HE, Rooney CM, et al. Characterization and treatment of chronic active Epstein-Barr virus disease: a 28-year experience in the United States. Blood 2011;117:5835-5849.
5 Okano M, Gross TG. Acute or chronic life-threatening diseases associated with Epstein-Barr virus infection. Am J Med Sci 2011;343:483-489.
7 Kanegane H, Wakiguchi H, Kanegane C, Kurashige T, Miyawaki T, Tosato G. Increased cell-free viral DNA in fatal cases of chronic active Epstein-Barr virus infection. Clin Infect Dis 1999;28:906-909.
8 Jo SA, Hwang SH, Kim SY, Shin HJ, Chung JS, Sol MY, et al. Quantitation of whole blood Epstein-Barr virus DNA is useful for assessing treatment response in patients with non-Hodgkin’s lymphoma. Int J Lab Hematol 2010;32:e106-113.
9 Khan G. Screening for Epstein-Barr virus in Hodgkin’s lymphoma. Methods Mol Biol 2009;511:311-322.
10 Suh N, Liapis H, Misdraji J, Brunt EM, Wang HL. Epstein-Barr virus hepatitis: diagnostic value of in situ hybridization, polymerase chain reaction, and immunohistochemistry on liver biopsy from immunocompetent patients. Am J Surg Pathol 2007;31:1403-1409.
11 Lee JH, Kim SH, Han SH, An JS, Lee ES, Kim YS. Clinicopathological and molecular characteristics of Epstein-Barr virus-associated gastric carcinoma: a meta-analysis. J Gastroenterol Hepatol 2009;24:354-365.
12 Kimura H, Morishima T, Kanegane H, Ohga S, Hoshino Y, Maeda A, et al. Prognostic factors for chronic active Epstein-Barr virus infection. J Infect Dis 2003;187:527-533.