頁籤選單縮合
題 名 | 傳染性單核球增多症併肝炎及腹水=Infectious Mononucleosis with Hepatitis and Ascites |
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作 者 | 張益國; 陳培榕; 周昱甫; 楊妙君; 李家鳳; | 書刊名 | 臺灣耳鼻喉頭頸外科雜誌 |
卷 期 | 45:2 2010.03-04[民99.03-04] |
頁 次 | 頁64-67 |
分類號 | 415.239 |
關鍵詞 | EB病毒; 肝炎; 肝功能異常; Epstein barr virus; Hepatitis; Liver dysfunction; |
語 文 | 中文(Chinese) |
中文摘要 | Epstein-Barrvirus(EB病毒)所造成感染性單核球增多症,有3個典型的症狀,包括發燒、喉嚨痛及淋巴結腫大。其亦常會引起肝炎,在免疫正常的病人中,通常是會自行恢復。其急性期的表現是膽汁鬱積性的,所以會造成黃膽及輕中度的肝功能異常。若慢性持續發炎時,有時會造成肝衰竭。有報告指出其與肝細胞癌有關。此一21歲案例,其主訴是發燒、喉嚨痛及疲倦多日。理學檢查發現頸部有淋巴結腫大、扁桃腺腫大化膿、皮疹及肝脾腫大。實驗室檢查發現其肝功能指數異常,EB病毒抗原濃度上升,EB病毒抗體IgG及IgM都呈現陽性,A,B,C三型肝炎抗體皆陰性。腹部超音波檢查顯示有輕微腹水。此疾病會嚴重到產生腹水的情況不多,予以支持性治療3星期後,肝功能漸恢復正常。我們提出此病例報告,主要凸顯其對肝臟的影響,包括黃疸、肝臟轉化脢異常、肝門區發炎以及腹部超音波上的異常。 |
英文摘要 | Epstein-Barr virus (EBV) often causes a triad of fever, sore throat, and lymphadenopathy, which is referred to as infectious mononucleosis. EBV hepatitis is an uncommon and almost self-limited disease in immunocompetent patients. Patients with acute EBV infections may develop cholestatic hepatitis with associated jaundice together with hepatitis with a moderate elevations in the level of transaminase. Splenic rupture, liver failure, autoimmune hepatitis and hepatocellular carcinoma may be associated with EBV due to acute and/or chronic EBV infection. We present the case of a 21-yearold man whose chief complaints were fever, sore throat and tiredness. The physical examination showed cervical lymphadenopathy, bilateral tonsils enlargement with a coating of exudate, maculopapular rush, splenomegaly and hepatomegaly. A laboratory analysis showed lymphocytosis, an elevation of the serum transaminase level together with the presence of bilirubin and GGT. An abdominal echo study revealed mild ascites. After 3 weeks of supportive treatment, liver function had returned to within the normal range. This article presents a case of EBV infection that shows clinically significant hepatitis and reviews the literature on the gastrointestinal complications associated with EBV. |
本系統中英文摘要資訊取自各篇刊載內容。