Clinical characteristics of 15 cases with chronic active Epstein-Barr virus infection

XIE Yangxin; ZHOU Zhiping; XU Wen; QIN Enqiang; ZHAO Min

doi:10.3969/j.issn.1671-6450.2014.05.016

Abstract：Objective To investigate the clinical characteristics of chronic active Epstein-Barr virus ( CAEBV) infec-tion cases.Methods Retrospective analyzed the clinical data , laboratory tests, treatment and follow-up results of 15 patients with chronic active EB virus infection .Results Chronic active EB virus common clinical manifestations were fever , hepato-splenomegaly, lymphadenopathy, others including cough, expectoration, rash, fatigue, jaundice, nasal congestion, runny nose, sore throat, chest tightness and other symptoms , the most common laboratory abnormalities are elevated aminotransferas-es, some accompanied by elevated bilirubin , blood system mainly finding are the whole series or two lines cytopenia decreased and increased the proportion of lymphocytes , including anemia , leukopenia , thrombocytopenia ,increased serum lactate dehy-drogenase and ferritin more common , and were significantly elevated in critically ill patients .All patients had anti-EB virus capsid antigen IgG ( EBVCA-IgG) antibodies increased , while the IgM antibodies were negative , 14 patients in the early de-tection of antigen EBEA-IgG antibodies and nuclear antigen EBNA-IgG antibodies, EBEA-IgG antibody positive in 12 cases, while EBNA-IgG antibody positive in 10 cases.Real-time quantitative polymerase chain reaction detection of EBV-DNA in pe-ripheral blood were positive, viral load (median) of 4.3 ×106 copies/ml.In 15 patients, one case were lost of follow up;eight cases were dead , including three cases of hemophagocytic syndrome , interstitial pneumonia in three cases , one case of liver failure, heart failure in one case; rest 6 cases are still under follow-up.Conclusion Diagnosis of CAEBV infection is difficult due to the variety of clinical features .It is important to test EB virus antibody and DNA for diagnosis as early as possi-ble because of its severe complications , poor prognosis and high mortality .