Abstract
BACKGROUND: Epstein-Barr virus infection shows variety of clinical features. Chronic fashion of the disease, called chronic Epstein-Barr virus infection, and acute aggressive manifestation of the disease, Epstein-Barr virus-associated hemophagocytic syndr ome sometimes show coronary dilatation resembling that of Kawasaki disease. In this study, we demonstrated coronary arterial lesions in patients with Epstein-Barr virus infection. METHOD: Four patients with Epstein-Barr virus infection were selected in t he study. Clinical characteristics, laboratory data, and echocardiograhpic findings were studied according to the hospital records. RESULT: Patients were aged from 1 to 15 years old. The distribution of gender was three girls and one boy. Clinical diagn osis was chronic Epstein-Barr virus infection in two patients and hemophagocytic syndrome in the remains. All four patients suffered coronary arterial dilatation which were demonstrated by echocardiography. The shape of coronary artery is linear. Corona r y aneurysm like Kawasaki disease were not observed. A 15 year-old boy with chronic Epstein-Barr virus infection suffered coronary dilatation and dilated cardiomyopathy. The patient died of cardiac failure. His autopsy revealed prominent lymphocytic inf ilt ra tion in the myocardium but no inflammatory cells in coronary artery. Ten year-old girl with chronic Epstein-Barr virus infection complained chest pain and showed coronary dilatation. She died of aggressive onset of hemophagocytic syndrome. Six year-old gi rl and one year-old girl with hemophagocytic syndrome also showed coronary dilatation at the onset. One year-old girl died of interstitial pneumonia. CONCLUSIONS: Epstein-Barr virus infection sometimes shows coronary artery dilatation like Kawasak i diseas e. The echocardiographic morphology of coronary lesion is not aneurysm but dilatation in our cases. Autopsy findings did not suggest acute inflammation around coronary artery. Coronary lesions may advance silently. Once the coronary lesions obser v ed, close cardiac follow up should be held.
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