Korean J Med > Volume 74(6); 2008 > Article
The Korean Journal of Medicine 2008;74(6):658-662.
A case of concomitant epstein-barr virus-induced hepatitis on chronic autoimmune hepatitis
Jae Gu Jung, Dong Gyu Moon, Hong Jun Yang, Jung Hyun Kwon, Jin Han Kang, Eun Sun Jung, Seung Kew Yoon
경희대학교 의과대학 순환기내과학교실
증례 : 자가면역성 간염에 동반된 Epstein-Barr virus에 의한 간염 1예
정재규, 문동규, 양홍준, 권정현, 강진한, 정은선, 윤승규
Abstract
Autoimmune hepatitis (AIH), a rare cause of chronic liver disease in Korea, is a chronic, predominantly periportal hepatitis characterized by hypergammaglobulinemia, tissue autoantibodies, and responsiveness to immunosuppressive therapy. Here we report a rare case of Epstein-Barr virus (EBV) hepatitis in the presence of a previous diagnosis of AIH. A 25-year-old woman was admitted to the hospital with fever and myalgias. Laboratory data showed elevated aminotransferases, hypergammaglobulinemia, increased anti-nuclear antibody (ANA) titer, positive anti-smooth muscle antibody (ASMA) test, negative anti-mitochondrial antibody (AMA) test, and negative antibody against liver kidney microsome-1 (anti-LKM-1) test. Serologic viral markers of EBV indicated a recent EBV infection. Liver biopsy was performed to search for evidence of accompanying autoimmune liver disease. Liver biopsy findings were consistent with chronic active hepatitis. In-situ hybridization performed on the liver tissue confirmed the presence of EBV DNA. The patient has been treated with prednisolone and has shown subsequent improvement in clinical symptoms and liver function tests.
Key Words: Autoimmune hepatitis; Epstein-Barr virus (EBV); Acute hepatitis


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