Comparison between sporadic cytomegalovirus hepatitis and Epstein-Barr virus hepatitis in previously healthy adults.

In order to determine the factors responsible for the differentiation of cytomegalovirus (CMV) hepatitis and Epstein-Barr virus (EBV) hepatitis, the clinical features and laboratory data of both types of hepatitis were retrospectively analyzed in 20 patients with CMV and 11 patients with EBV. While most signs and symptoms of CMV and EBV hepatitis showed no significant differences, we found that cervical lymph- adenopathy was more common in EBV hepatitis than in CMV hepatitis (p < 0.01). Frequency of epigastralgia was more common in CMV hepatitis than EBV hepatitis (p < 0.05). The percentage of peripheral blood monocytes in the white blood cell count in CMV hepatitis was greater than in EBV hepatitis (p < 0.01). Low CD4 levels and high CD8 levels made CD4/CD8 low in peripheral lymphocytes of both groups of hepatitis. Ten EBV hepatitis patients received antibiotics in the early stage of the disease in which two (25%) developed severe erythematous rashes. Four CMV hepatitis patients received antibiotics and did not develop rashes. Identification of early clinical parameters capable of differentiating CMV hepatitis from EBV hepatitis is important.

[1]  T. The,et al.  Cytomegalovirus hepatitis in normal and immune compromised hosts. , 2008, Liver.

[2]  P. Wutzler,et al.  Serological diagnosis of infectious mononucleosis using three anti-Epstein-Barr virus recombinant ELISAs. , 1993, Journal of virological methods.

[3]  W. Britt,et al.  Evaluation of a microtiter plate fluorescent-antibody assay for rapid detection of human cytomegalovirus infection , 1992, Journal of clinical microbiology.

[4]  Pauszek Me.  Making a rash diagnosis: amoxicillin therapy in infectious mononucleosis. , 1990 .

[5]  G. Krueger,et al.  Overview of immunopathology of chronic active herpesvirus infection. , 1988, Journal of virological methods.

[6]  R. Markin,et al.  Rapid Identification of Cytomegalovirus in Liver Allograft Biopsies by In Situ Hybridization , 1988, The American journal of surgical pathology.

[7]  J. Gerstoft,et al.  An enzyme labelled nuclear antigen immunoassay for detection of cytomegalovirus IgM antibodies in human serum: Specific and non‐specific reactions , 1987, Journal of medical virology.

[8]  R. Dodd,et al.  A test for human cytomegalovirus-specific immunoglobulins using a modification of a commercial test kit. , 1987, Journal of virological methods.

[9]  J. Nelson,et al.  Detection of human cytomegalovirus in peripheral blood lymphocytes in a natural infection. , 1985, Science.

[10]  P. Griffiths,et al.  A seroepidemiological study of cytomegalovirus and Epstein-Barr virus in rheumatoid arthritis and sicca syndrome. , 1985, Annals of the rheumatic diseases.

[11]  D. Snover,et al.  Liver Disease in Cytomegalovirus Mononucleosis: A Light Microscopical and Immunoperoxidase Study of Six Cases , 1984, Hepatology.

[12]  S. Sacks,et al.  Cytomegalovirus hepatitis: evidence for direct hepatic viral infection using monoclonal antibodies. , 1984, Gastroenterology.

[13]  J. Wehner,et al.  Enzymatic formation of zinc-protoporphyrin by rat liver and its potential effect on hepatic heme metabolism , 1983 .

[14]  E. Rieber,et al.  Involvement of the cytotoxic/suppressor T-cell subset in liver tissue injury of patients with acute and chronic liver diseases , 1983 .

[15]  Keeling Rp,et al.  Beta-hemolytic streptococcal pharyngitis: uncommon in infectious mononucleosis. , 1983 .

[16]  Y. Siegman-Igra.  Late postoperative fever--viral infection following multiple blood transfusion. , 1983, Israel journal of medical sciences.

[17]  Richard Smith,et al.  Infection with cytomegalovirus during pregnancy: specific IgM antibodies as a marker of recent primary infection. , 1982, The Journal of infectious diseases.

[18]  J. Whitcher,et al.  Antibody to cytomegalovirus in patients with Sjögren's syndrome. As determined by an enzyme-linked immunosorbent assay. , 1982, Arthritis and rheumatism.

[19]  A. V. van Loon,et al.  Direct enzyme-linked immunosorbent assay that uses peroxidase-labeled antigen for determination of immunoglobulin M antibody to cytomegalovirus , 1981, Journal of clinical microbiology.

[20]  T. Ziegler,et al.  Solid-phase enzyme immunoassay for determination of antibodies to cytomegalovirus , 1980, Journal of clinical microbiology.

[21]  M. D. Burke,et al.  Hepatic function in mononucleosis induced by Epstein-Barr virus and cytomegalovirus. , 1980, Clinical chemistry.

[22]  C. Liu,et al.  Disseminated intravascular coagulation and hepatic necrosis. Complications of infectious mononucleosis. , 1976, JAMA.

[23]  A. Evans,et al.  A prospective evaluation of heterophile and Epstein-Barr virus-specific IgM antibody tests in clinical and subclinical infectious mononucleosis: Specificity and sensitivity of the tests and persistence of antibody. , 1975, The Journal of infectious diseases.

[24]  J. Adlard,et al.  Lymphopenic infectious mononucleosis. , 1975, Archives of internal medicine.

[25]  K. Hizawa,et al.  GENERALIZED CYTOMEGALIC INCLUSION DISEASE PRESENTING AN INFECTIOUS MONONUCLEOSIS SYNDROME (SO‐CALLED CYTOMEGALOVIRUS MONONUCLEOSIS) IN A PREVIOUSLY HEALTHY ADULT—AN AUTOPSY STUDY— , 1972, Acta pathologica japonica.

[26]  Y. Numazaki,et al.  Primary infection with human cytomegalovirus: virus isolation from healthy infants and pregnant women. , 1970, American journal of epidemiology.

[27]  Roger Williams,et al.  Cytomegalovirus hepatitis in the adult. , 1967, Lancet.

[28]  L. Kääriäinen,et al.  Cytomegalovirus as a possible cause of a disease resembling infectious mononucleosis. , 1965, British medical journal.

[29]  T. Lazzarotto,et al.  Enzyme‐linked immunoadsorbent assay for the detection of cytomegalovirus‐IgM: Comparison between eight commercial kits, immunofluorescence, and immunoblotting , 1992, Journal of clinical laboratory analysis.

[30]  M. Tadokoro,et al.  [A case of cytomegalovirus hepatitis in an aged healthy woman]. , 1992, Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology.

[31]  Kyoichi Inoue,et al.  Immunohistochemical studies on the mechanism of hepatocellular injury of acute CMV hepatitis in previously healthy adults. , 1989 .

[32]  E. Torfason,et al.  False RIA IgM titres to herpes simplex virus and cytomegalovirus: Factors causing them, and their absorption by protein A‐sepharose/IgG‐protein A‐sepharose , 1982, Journal of medical virology.

[33]  T. Bergan,et al.  Temporary skin reactions to penicillins during the acute stage of infectious mononucleosis. , 1975, Scandinavian journal of infectious diseases.