Five adult cases of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis

Yasunobu Abe, Motoaki Shiratsuchi, Eriko Nagasawa, Rie Ohtsuka, Junichi Kiyasu, Eriko Sada, Kensaku Idutsu, Kazuhiro Kotoh, Junji Nishimura, Shouichi Ohga, Ryoichi Takayanagi

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Abstract

Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) is more common in children, and is characterized by pancytopenia, liver dysfunction and coagulopathy caused by interactions between EBV-infected T cells and activated macrophages. We describe here five adults with EBV-HLH. The median age was 17 years (range 16 approximately 40). HLH developed in 4 patients within 2 months after the primary infection, and in the other one during the reactivation. All patients had a high EBV viral load in peripheral blood (2 x 10(2)-3 x 10(6) copies/ml) and monoclonal proliferation of EBV-infected T cells. All patients received immunosuppressive therapy with or without etoposide, and two patients required plasmapheresis due to the severity. Three patients are alive in complete remission (follow up periods; 13, 19, 30 months), while two patients became refractory to chemo-immunotherapy and died despite multidrug chemotherapy. EBV-HLH should be more widely recognized in adults in order to achieve early diagnosis and appropriate treatment.

Original languageEnglish
Pages (from-to)74-79
Number of pages6
Journal[Rinshō ketsueki] The Japanese journal of clinical hematology
Volume51
Issue number1
Publication statusPublished - Jan 2010

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All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Abe, Y., Shiratsuchi, M., Nagasawa, E., Ohtsuka, R., Kiyasu, J., Sada, E., ... Takayanagi, R. (2010). Five adult cases of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis. [Rinshō ketsueki] The Japanese journal of clinical hematology, 51(1), 74-79.