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Chronic active Epstein-Barr virus infection involving gastrointestinal tract mimicking inflammatory bowel disease
BACKGROUND: Chronic active Epstein-Barr virus infection (CAEBV) is a rare disease, which is difficult to be differentiated from inflammatory bowel disease (IBD). To cause the attention, we present twelve cases of CAEBV in immunocompetent patients with gastrointestinal tract involvement. METHODS: Twe...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410156/ https://www.ncbi.nlm.nih.gov/pubmed/32758149 http://dx.doi.org/10.1186/s12876-020-01395-9 |
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author | Xu, Weijia Jiang, Xiaoyun Chen, Jiajie Mao, Qiqi Zhao, Xianguang Sun, Xu Zhong, Liang Rong, Lan |
author_facet | Xu, Weijia Jiang, Xiaoyun Chen, Jiajie Mao, Qiqi Zhao, Xianguang Sun, Xu Zhong, Liang Rong, Lan |
author_sort | Xu, Weijia |
collection | PubMed |
description | BACKGROUND: Chronic active Epstein-Barr virus infection (CAEBV) is a rare disease, which is difficult to be differentiated from inflammatory bowel disease (IBD). To cause the attention, we present twelve cases of CAEBV in immunocompetent patients with gastrointestinal tract involvement. METHODS: Twelve patients who fulfilled the diagnostic criteria of CAEBV were enrolled in this retrospective study. The control group was consisted of twenty-four IBD patients with EBV-DNA value increased in peripheral blood. The clinicopathologic and endoscopic characteristics were reviewed and analyzed. RESULTS: The major clinical presentations of CAEBV patients were intermittent fever (100%), hepatomegaly/splenomegaly (58%), lymphadenopathy (50%), diarrhea (50%) and hematochezia (50%). Compared with IBD patients, the incidence of intermittent fever and increased level of ferritin were significantly higher among CAEBV patients. The median values for EBV detected in peripheral blood were significantly higher in CAEBV group (1.42*10^6 copies/μg) than in IBD group (3.2*10^3 copies/μg, p<0.05). The main endoscopic findings of CAEBV included multifocal or isolated, irregular, multiform ulcers and diffuse inflammation, lacking of typical cobblestone appearance. Ten patients died within 5 years of disease onset. The average survival time is 21 months. CONCLUSIONS: Symptoms such as intermittent fever, increased level of ferritin and atypical endoscopic findings could be a sign for CAEBV. Early detections of EBV-DNA in serum and EBV-encoded small nuclear RNA (EBER) by in situ hybridization in intestinal tissue are essential for differential diagnosis between CAEBV and IBD. |
format | Online Article Text |
id | pubmed-7410156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-74101562020-08-10 Chronic active Epstein-Barr virus infection involving gastrointestinal tract mimicking inflammatory bowel disease Xu, Weijia Jiang, Xiaoyun Chen, Jiajie Mao, Qiqi Zhao, Xianguang Sun, Xu Zhong, Liang Rong, Lan BMC Gastroenterol Research Article BACKGROUND: Chronic active Epstein-Barr virus infection (CAEBV) is a rare disease, which is difficult to be differentiated from inflammatory bowel disease (IBD). To cause the attention, we present twelve cases of CAEBV in immunocompetent patients with gastrointestinal tract involvement. METHODS: Twelve patients who fulfilled the diagnostic criteria of CAEBV were enrolled in this retrospective study. The control group was consisted of twenty-four IBD patients with EBV-DNA value increased in peripheral blood. The clinicopathologic and endoscopic characteristics were reviewed and analyzed. RESULTS: The major clinical presentations of CAEBV patients were intermittent fever (100%), hepatomegaly/splenomegaly (58%), lymphadenopathy (50%), diarrhea (50%) and hematochezia (50%). Compared with IBD patients, the incidence of intermittent fever and increased level of ferritin were significantly higher among CAEBV patients. The median values for EBV detected in peripheral blood were significantly higher in CAEBV group (1.42*10^6 copies/μg) than in IBD group (3.2*10^3 copies/μg, p<0.05). The main endoscopic findings of CAEBV included multifocal or isolated, irregular, multiform ulcers and diffuse inflammation, lacking of typical cobblestone appearance. Ten patients died within 5 years of disease onset. The average survival time is 21 months. CONCLUSIONS: Symptoms such as intermittent fever, increased level of ferritin and atypical endoscopic findings could be a sign for CAEBV. Early detections of EBV-DNA in serum and EBV-encoded small nuclear RNA (EBER) by in situ hybridization in intestinal tissue are essential for differential diagnosis between CAEBV and IBD. BioMed Central 2020-08-05 /pmc/articles/PMC7410156/ /pubmed/32758149 http://dx.doi.org/10.1186/s12876-020-01395-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Xu, Weijia Jiang, Xiaoyun Chen, Jiajie Mao, Qiqi Zhao, Xianguang Sun, Xu Zhong, Liang Rong, Lan Chronic active Epstein-Barr virus infection involving gastrointestinal tract mimicking inflammatory bowel disease |
title | Chronic active Epstein-Barr virus infection involving gastrointestinal tract mimicking inflammatory bowel disease |
title_full | Chronic active Epstein-Barr virus infection involving gastrointestinal tract mimicking inflammatory bowel disease |
title_fullStr | Chronic active Epstein-Barr virus infection involving gastrointestinal tract mimicking inflammatory bowel disease |
title_full_unstemmed | Chronic active Epstein-Barr virus infection involving gastrointestinal tract mimicking inflammatory bowel disease |
title_short | Chronic active Epstein-Barr virus infection involving gastrointestinal tract mimicking inflammatory bowel disease |
title_sort | chronic active epstein-barr virus infection involving gastrointestinal tract mimicking inflammatory bowel disease |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410156/ https://www.ncbi.nlm.nih.gov/pubmed/32758149 http://dx.doi.org/10.1186/s12876-020-01395-9 |
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