Selective Effect of Prednisolone on Severe Cardiac Complications in a Patient with Chronic Active Epstein-Barr Virus Infection

Abstract

A 10-year-old boy developed fever, facial edema, persistent sinusitis, hepatosplenomegaly with liver dysfunction, and intractable diarrhea lasting for 3 weeks. A diagnosis of chronic active Epstein-Barr virus infection (CAEBV) was made. A variety of therapeutic interventions including aciclovir, ganciclovir, intravenous gamma-globulin, interferon-alpha, interleukin-2, and VP-16 was ineffective, and he developed ventricular tachycardia associated with cardiac tamponade. The administration of oral prednisolone therapy induced prompt resolution of cardiac complications without notable benefit to systemic manifestations. The patient died of liver failure one year later. Our observations suggest that cardiac complications of CAEBV may have a distinct pathological mechanism from those which induce systemic disease activities.