Epstein–Barr Virus-Associated Gastritis: A Case Report

Abstract

Keywords Infectious mononucleosis Epstein–Barrvirus-associated gastritis Epstein–Barr nuclear antigen Endoscopic ultrasoundAbbreviationsEBER Epstein–Barr virus-encoded small RNAsEBV Epstein–Barr virusEUS Endoscopic ultrasonographyEGD EsophagogastroduodenoscopyIM Infectious mononucleosisIntroductionInfectious mononucleosis (IM), caused by Epstein–Barrvirus (EBV), presents with fever, pharyngitis, and lym-phadenopathy [1]. Gastrointestinal tract involvement isextremely rare. EBV-associated gastritis is difficult todistinguish from gastric malignancies such as gastric car-cinoma and malignant lymphoma [2]. We report a 37-year-old man with EBV-associated gastritis complicated withcerebellar encephalitis.Case ReportA 37-year-old man noticed general fatigue, sore throat,slight fever, and dizziness without abdominal symptoms.He underwent an appendectomy at 17 years old and tookno medications. Blood examination at another clinicrevealed elevated liver enzymes (AST, 124 IU/l; ALT,100 IU/l) and 3 % atypical lymphocytes among all whiteblood cells. He was referred to our hospital.Physical examination revealed no positive findings.Ultrasonography revealed slight splenomegaly. Esophago-gastroduodenoscopy (EGD) revealed shallow, depressedulcerative lesions in the posterior wall of the antrum andgastric angle with elevated, irregular margins (Fig. 1). Thecytomegalovirus IgM antibody level was negative. IgMantibody of EBV viral capsid antigen (EBV-VCA) waspositive (209). IgG antibodies of EBV-VCA and Epstein–Barr nuclear antigen were negative. From these data, IM