{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:17:33Z","timestamp":1790371053443,"version":"4.1.0"},"reference-count":7,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T00:00:00Z","timestamp":1603324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We present a 23\u2010year\u2010old man with hemophagocytic lymphohistiocytosis (HLH) triggered by Epstein\u2013Bar virus (EBV) infection. This patient presented with persistent fever and acute liver injury 6\u2009weeks after having an infectious mononucleosis associated with EBV infection. He had hypofibrinogenemia, hyperferritinemia, increased soluble interleukin\u20102 receptor, elevated prothrombin time, and pancytopenia. Bone marrow examination for evaluation of pancytopenia revealed that macrophages had phagocytosed mature erythrocytes. Based on these findings, we suspected an HLH triggered by EBV infection (EBV\u2010HLH). To distinguish from HLH triggered by malignant lymphomas accompanying EBV infection, we performed a percutaneous liver biopsy, which revealed that atypical T\u2010lymphocytes had infiltrated the liver tissues. The T\u2010lymphocytes were positive for EBV\u2010encoded RNA in situ hybridization, and no distinct monoclonal T\u2010cell receptor chain gene rearrangement was detected. These findings indicated EBV hepatitis and, accordingly, malignant lymphoma was ruled out. We finally made a diagnosis of EBV\u2010HLH. The patient was treated with corticosteroid and etoposide, according to HLH\u20102004 guideline recommendations, and the patient's symptoms and laboratory values improved. After that, he experienced no recurrence. Prompt recognition and initiation of treatment remains the key to the survival of patients with EBV\u2010HLH, and the liver biopsy was helpful in making the diagnosis.<\/jats:p>","DOI":"10.1002\/jgh3.12439","type":"journal-article","created":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T18:31:13Z","timestamp":1603391473000},"page":"166-168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Acute liver injury secondary to hemophagocytic lymphohistiocytosis triggered by <scp>Epstein\u2013Barr<\/scp> virus infection"],"prefix":"10.1002","volume":"5","author":[{"given":"Aiji","family":"Hattori","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Saiseikai Matsusaka General Hospital  Matsusaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5564-184X","authenticated-orcid":false,"given":"Yasuhiko","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Mie University Hospital  Tsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Kawabata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saiseikai Matsusaka General Hospital  Matsusaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1402-7832","authenticated-orcid":false,"given":"Kyosuke","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Mie University Hospital  Tsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,22]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61048-X"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.01902"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/10245332.2018.1491093"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2013-008979"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-03-278127"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.198655"}],"container-title":["JGH Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.12439","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jgh3.12439","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.12439","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T10:51:02Z","timestamp":1693306262000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgh3.12439"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,22]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1002\/jgh3.12439"],"URL":"https:\/\/doi.org\/10.1002\/jgh3.12439","archive":["Portico"],"relation":{},"ISSN":["2397-9070","2397-9070"],"issn-type":[{"value":"2397-9070","type":"print"},{"value":"2397-9070","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,22]]},"assertion":[{"value":"2020-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}