Chronic Active Epstein-Barr Virus Disease Causes Tubulointerstitial Nephritis and Growth Failure.
Naoaki Mikami, Ayumi Shimizu, Yuichi Yokokawa et al.
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Case in brief
A 9-year-old girl presented with fever, malaise, anemia, kidney dysfunction, and growth retardation. Initial diagnosis was acute tubulointerstitial nephritis based on biopsy. Further testing revealed EBV-infected CD4+ T cells in the kidney and bone marrow, leading to a diagnosis of chronic active EBV disease. Despite chemotherapy, she developed complications and died three months later. Her history included recurrent pyogenic lymphadenitis with prior EBV detection.
What made this case unusual
This case highlights the rare involvement of the kidneys and growth failure in chronic active Epstein-Barr virus disease, which is typically associated with systemic symptoms.
Diagnostic / clinical pearl
Clinicians should consider chronic active EBV disease in patients with atypical presentations, such as kidney dysfunction and growth failure, and utilize advanced diagnostic techniques for early detection.
Why it matters
Recognizing the potential for chronic active EBV disease to present with renal involvement can lead to timely diagnosis and management, which is crucial given its life-threatening nature.