Autoimmune hepatitis type-2 and Epstein-Barr virus infection in a toddler: Art of facts or an artifact?

Aglaia Zellos, Vana Spoulou, Eleftheria Roma-Giannikou, Ourania Karentzou, George N. Dalekos, Maria Theodoridou

Research output: Contribution to journalArticle

Abstract

Epstein-Barr virus (EBV) can cause frequently asymptomatic (or anicteric) and self-limited hepatitis, while occasionally may result in considerable cholestatic hepatitis. Herein, we describe the case of a previously healthy toddler (26 month old girl) with prolonged cholestasis, elevated serum transaminases, EBV serology compatible with recent EBV infection and positive anti liver kidney microsomal antibody type 1 which is characteristic of new-onset autoimmune hepatitis type 2. Liver biopsy was also typical of autoimmune hepatitis as attested by the presence of portal inflammation with predominant T-lymphocytes and plasma cells and interface hepatitis. Persistent EBV-related hepatitis was excluded by the absence of viral inclusions and steatosis on liver specimens and negative liver EBV-PCR. In conclusion, our case strongly suggests that in children with prolonged cholestatic hepatitis, positive EBV serology cannot exclude the presence of other causes of liver disease. In this context, autoimmune hepatitis should be considered as an alternate diagnosis, particularly when there is specific liver-related autoantibody detection. In such conditions, liver biopsy seems mandatory in an attempt to achieve a correct and timely diagnosis of a potentially catastrophic disease as autoimmune hepatitis. Although some cases of autoimmune hepatitis type 1 following EBV infection have been reported in adults, to the best of our knowledge, the present case of autoimmune hepatitis type 2 after EBV infection represents the first case in children ever reported in the English literature.

Original languageEnglish (US)
Pages (from-to)147-151
Number of pages5
JournalAnnals of Hepatology
Volume12
Issue number1
StatePublished - Jan 2013
Externally publishedYes

Fingerprint

Autoimmune Hepatitis
Epstein-Barr Virus Infections
Art
Artifacts
Human Herpesvirus 4
Hepatitis
Liver
Serology
Literature
Biopsy
Cholestasis
Fatty Liver
Transaminases
Plasma Cells
Autoantibodies
Liver Diseases
Inflammation
T-Lymphocytes
Kidney
Polymerase Chain Reaction

Keywords

  • Autoimmune liver diseases
  • Children
  • Cholestasis
  • Epstein-Barr infection
  • Liver kidney microsome antibodies

ASJC Scopus subject areas

  • Hepatology

Cite this

Zellos, A., Spoulou, V., Roma-Giannikou, E., Karentzou, O., Dalekos, G. N., & Theodoridou, M. (2013). Autoimmune hepatitis type-2 and Epstein-Barr virus infection in a toddler: Art of facts or an artifact? Annals of Hepatology, 12(1), 147-151.

Autoimmune hepatitis type-2 and Epstein-Barr virus infection in a toddler : Art of facts or an artifact? / Zellos, Aglaia; Spoulou, Vana; Roma-Giannikou, Eleftheria; Karentzou, Ourania; Dalekos, George N.; Theodoridou, Maria.

In: Annals of Hepatology, Vol. 12, No. 1, 01.2013, p. 147-151.

Research output: Contribution to journalArticle

Zellos, A, Spoulou, V, Roma-Giannikou, E, Karentzou, O, Dalekos, GN & Theodoridou, M 2013, 'Autoimmune hepatitis type-2 and Epstein-Barr virus infection in a toddler: Art of facts or an artifact?', Annals of Hepatology, vol. 12, no. 1, pp. 147-151.
Zellos A, Spoulou V, Roma-Giannikou E, Karentzou O, Dalekos GN, Theodoridou M. Autoimmune hepatitis type-2 and Epstein-Barr virus infection in a toddler: Art of facts or an artifact? Annals of Hepatology. 2013 Jan;12(1):147-151.
Zellos, Aglaia ; Spoulou, Vana ; Roma-Giannikou, Eleftheria ; Karentzou, Ourania ; Dalekos, George N. ; Theodoridou, Maria. / Autoimmune hepatitis type-2 and Epstein-Barr virus infection in a toddler : Art of facts or an artifact?. In: Annals of Hepatology. 2013 ; Vol. 12, No. 1. pp. 147-151.
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