TY - JOUR

T1 - Severe ulcerative oesophagitis caused by primary Epstein-Barr virus infection in an immunocompetent individual

AU - Lorentsen, Ruben Due

AU - Klarskov, Louise Laurberg

AU - Steenholdt, Casper

N1 - Publisher Copyright: ©

PY - 2021/1/25

Y1 - 2021/1/25

N2 - Epstein-Barr virus (EBV) infects the vast majority of the human population. The primary infection in immunocompetent individuals is typically asymptomatic or presenting as infectious mononucleosis. Here, an 18-year-old man without medical history was admitted with mild non-specific symptoms of infection presenting primarily with severe dysphagia and epigastric pain. Gastroscopy revealed severe, extensive, ulcerative oesophagitis with suspicion of Crohn's disease. However, a diagnosis of primary EBV infection presenting as severe ulcerative oesophagitis and without systemic symptoms of infectious mononucleosis was made based on dynamic changes in EBV serology (shift from IgM to IgG positivity), EBV-specific immunohistochemical staining, and PCR analysis of biopsy specimens. This rare manifestation of primary EBV in an immunocompetent patient was treated symptomatically and resolved within a few weeks, and should be considered a differential diagnosis at otherwise unexplained ulcerative oesophagitis in younger individuals.

AB - Epstein-Barr virus (EBV) infects the vast majority of the human population. The primary infection in immunocompetent individuals is typically asymptomatic or presenting as infectious mononucleosis. Here, an 18-year-old man without medical history was admitted with mild non-specific symptoms of infection presenting primarily with severe dysphagia and epigastric pain. Gastroscopy revealed severe, extensive, ulcerative oesophagitis with suspicion of Crohn's disease. However, a diagnosis of primary EBV infection presenting as severe ulcerative oesophagitis and without systemic symptoms of infectious mononucleosis was made based on dynamic changes in EBV serology (shift from IgM to IgG positivity), EBV-specific immunohistochemical staining, and PCR analysis of biopsy specimens. This rare manifestation of primary EBV in an immunocompetent patient was treated symptomatically and resolved within a few weeks, and should be considered a differential diagnosis at otherwise unexplained ulcerative oesophagitis in younger individuals.

KW - clinical decision making

KW - endoscopy

KW - erosive oesophagitis

KW - infectious disease

U2 - 10.1136/bmjgast-2020-000586

DO - 10.1136/bmjgast-2020-000586

M3 - Letter

C2 - 33495156

AN - SCOPUS:85099979474

VL - 8

JO - B M J Open Gastroenterology

JF - B M J Open Gastroenterology

SN - 2054-4774

IS - 1

M1 - e000586

ER -