背景:爱泼斯坦-巴尔病毒(EBV)感染与多种疾病相关,可涉及多个器官和系统,临床表现复杂且无特异性,易误诊。以面颊部持续性多形性红斑(EM)为主要表现的慢性EBV感染非常罕见,鲜有报道。
方法:本文报道1例女性慢性EBV感染,面部慢性对称性红斑病变4年,因畏光而加剧,流泪,过敏性紫癜(HSP)样皮疹,粒细胞和红细胞谱系下降,血尿,和蛋白尿1周。
方法:该疾病最初被误诊为系统性红斑狼疮(SLE),后来通过皮肤活检证实为慢性EBV感染。在案件中,EBV感染不仅引起慢性面部EM,还可诱发急性HSP和紫癜性肾炎(血尿和蛋白尿型)。
方法:患儿接受1周足量糖皮质激素联合阿昔洛韦抗病毒治疗和3次血液灌流治疗。放电后,患者口服醋酸泼尼松(15mg,每日2次)1个月后停药.
结果:患者出院,皮疹缓解,血常规、尿常规正常。经过13个月的长期随访,她的面部红斑和色素沉着变得更轻,全身没有新的皮疹,全血细胞计数和尿检连续监测无异常。
结论:此病例提示青少年女性患有慢性面部EM皮疹和多器官和系统损伤,需要警惕慢性EBV感染,除了结缔组织疾病如SLE。
BACKGROUND: Epstein-Barr virus (EBV) infection is associated with a variety of diseases and can involve multiple organs and systems, with complex and nonspecific clinical manifestations that are easily misdiagnosed. Chronic EBV infection with persistent erythema multiforme (EM) on the cheek as the main manifestation is very rare and has been reported rarely.
METHODS: This article reports a case of an adolescent female with chronic EBV infection who presented with chronic symmetrical erythema lesions on the face for 4 years, exacerbated with photophobia, lacrimation, Henoch-Schonlein purpura (HSP)-like rash, decline in granulocyte and erythrocyte lineages, hematuria, and proteinuria for 1 week.
METHODS: The disease was initially misdiagnosed as systemic lupus erythematosus (SLE) and later confirmed as chronic EBV infection by skin biopsy. In the case, EBV infection not only caused chronic facial EM, but also induced acute HSP and purpura nephritis (hematuria and proteinuria type).
METHODS: The child was treated with 1 week of glucocorticosteroids in adequate doses combined with acyclovir antiviral therapy and 3 sessions of hemoperfusion. After discharge, she took prednisone acetate (15 mg twice a day) orally for 1 month and then discontinued.
RESULTS: She was discharged with her rash relieved and normal blood routine test and urine routine test. After 13 months of long-term follow-up, her facial erythema and hyperpigmentation became lighter, and there was no new rash on the whole body, and no abnormality in continuous monitoring of complete blood count and urine test.
CONCLUSIONS: This case suggests the need to be alert for chronic EBV infection in adolescent females with chronic facial EM rash and multiple organs and systems injury, in addition to connective tissue diseases such as SLE.