Year 2017 / Volume 109 / Number 5
Case Report
Severe acute hepatitis and cold agglutinin-related hemolytic anemia secondary to prime infection with Epstein-Barr virus

388-390

DOI: 10.17235/reed.2017.4072/2015

Guillermo Ontanilla Clavijo, Julia Praena Segovia, Álvaro Giráldez Gallego, María Elisa Cordero Matía, José Manuel Sousa Martín,

Abstract
Epstein-Barr virus, a member of the Herpesviridae family, is responsible for the infectious mononucleosis clinical syndrome, which mainly includes the pharyngitis, fever, and lymphadenopathy triad after incubation for 30-50 days. The liver is involved in 80-90% of patients in a self-limiting transient manner, with jaundice being much more uncommon (5%). From a hematological standpoint it may manifest aplastic anemia, neutropenia, and thrombocytopenia. We report a case of infectious mononucleosis that included severe acute hepatitis and was associated with severe hemolytic anemia secondary to cold agglutinins. After exclusion of other etiologies, and given the clinical suspicion of the above association, which was later confirmed by lab tests, empiric therapy was initiated with antiviral agents (aciclovir + valganciclovir) and corticoids, which resulted in a progressive clinical improvement until complete remission. Therefore, we believe that this case report will reinforce the clinical evidence in support of the above combined therapy for serious infectious mononucleosis as a step prior to liver transplantation.
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Ontanilla Clavijo G, Praena Segovia J, Giráldez Gallego Á, Cordero Matía M, Sousa Martín J. Severe acute hepatitis and cold agglutinin-related hemolytic anemia secondary to prime infection with Epstein-Barr virus . 4072/2015


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Publication history

Received: 28/10/2015

Accepted: 01/12/2016

Online First: 03/04/2017

Published: 03/05/2017

Article revision time: 394 days

Article Online First time: 523 days

Article editing time: 553 days


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