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KMID : 0387820230300020080
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Clinical Pediatric Hematology-Oncology
2023 Volume.30 No. 2 p.80 ~ p.84
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Case of Chronic Active Epstein-Barr Virus Infection Developed Hemophagocytic Lymphohistiocytosis after COVID-19 Infection
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Jo Su-Min
Jung Hye-Lim
Min Jung-Whan
Kim Eun-Sil
Yang A-Ram
Lim Kyung-Hwan
Kim Deok-Soo
Shim Jung-Yeon
Shim Jae-Won
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Abstract
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In children, prolonged primary Epstein-Barr virus (EBV) infection or reactivation may lead to the development of T or natural killer cell lymphoproliferative disorders, clas-sified as chronic active EBV infection (CAEBV). CAEBV is a prolonged systemic illness lasting beyond three months, with elevated EBV DNA levels in the serum or affected tissue and a lack of underlying immunodeficiency. Notably, EBV is the most common virus that induces secondary hemophagocytic lymphohistiocytosis (HLH), and Coronavirus disease 2019 (COVID-19) has been reported to trigger HLH. We present the case of a 20-year-old Korean male who was diagnosed with CAEBV and devel-oped HLH after being infected with COVID-19. The patient met 7 out of 8 criteria for HLH. Following treatment with corticosteroids and intravenous immunoglobulin, the patient recovered from HLH without additional chemotherapy. HLH treatment should be tailored to each patient based on clinical presentation and disease severity. Prolonged and regular evaluation for developing HLH or lymphoma is necessary for patients with CAEBV.
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KEYWORD
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Epstein-Barr virus infections, Chronic active Epstein-Barr virus infection, Hemophagocytic lymphohistiocytosis, COVID-19
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