Epstein-Barr virus-associated acute renal failure: Diagnosis, treatment, and follow-up

Jeng D. Tsai, Hung Chang Lee, Chun Chen Lin, Der Cherng Liang, Shu Huey Chen, Fu Yuan Huang

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Abstract

We retrospectively reviewed our experience of Epstein-Barr virus (EBV)-associated acute renal failure. Of 165 previously healthy children hospitalized with serologically proven primary EBV infection, 8 had acute renal failure, of whom 5 (group A) did not have virus-associated hemophagocytic syndrome (VAHS), while 3 (group B) did have VAHS. All had complications in four or more organ systems. Two patients in group A had renal biopsies showing acute tubulointerstitial nephritis, and the clinical and laboratory findings in the other 3 group A patients were consistent with acute tubulointerstitial nephritis. Acyclovir was used in 1 patient, but she died of hepatic failure and pulmonary hemorrhage. The other 4 spontaneously recovered renal function after supportive care, including hemodialysis in 1 patient. Our experience does not support the routine use of corticosteroids or antiviral agents in these patients. Children in group B had a relatively normal urinalysis. Renal biopsies were not performed, but their presentations were compatible with acute tubular necrosis. We conclude that EBV should be considered as a possible etiological agent in all children presenting with acute renal failure of unknown cause. The diagnosis depends on a high index of suspicion and careful serological evaluation in atypical cases.

Original languageEnglish
Pages (from-to)667-674
Number of pages8
JournalPediatric Nephrology
Volume18
Issue number7
Publication statusPublished - Jul 1 2003
Externally publishedYes

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Keywords

  • Acute renal failure
  • Acute tubular necrosis
  • Acute tubulointerstitial nephritis
  • Corticosteroids
  • Epstein-Barr virus
  • Virus-associated hemophagocytic syndrome

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Tsai, J. D., Lee, H. C., Lin, C. C., Liang, D. C., Chen, S. H., & Huang, F. Y. (2003). Epstein-Barr virus-associated acute renal failure: Diagnosis, treatment, and follow-up. Pediatric Nephrology, 18(7), 667-674.