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Abstract
Infectious mononucleosis caused by primary infection of Epstein-Barr virus (EBV) is a self-limiting lymphoproliferative disease, and shows concomitant clinical features such as pyrexia, anorexia, sore throat, cervical lymphadenopathy, liver dysfunction and hepatosplenomegaly. In rare cases, EBV establishes a latent infection in B lymphocytes and runs a chronic course and shows infectious mononucleosis-like symptoms repeatedly. This syndrome, named chronic active EBV infection, may trigger an autoimmune disease that mainly affectes the liver and red blood cells, and carries a very poor prognosis. The cardiovascular complications of chronic active EBV infection are very rare and may be associated with coronary arterial disease. This case describes a 5-year-old boy, who developed chronic active EBV infection and was diagnosed as having autoimmune hepatitis with a coronary aneurysm.
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Fig. 2
EBV was observed in many lymphocytes by in situ hybridization in the cervical lymph node (dark stained cells) (immunochemicalhistostaining, ×400).
Fig. 3
Multiple conglomerated lymph nodes are found around both upper internal jugular, mid jugular, lower jugular, posterior triangular, submandibular and submental area (A), supraclavicular area (B), Rt. subcarina, paraesophageal area (C), abdominal aorta, inferior vena cava, celiac axis and mesenteric roots (D).
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