Kulkarni, Radhika, Basheer, Amjad, Khan, Aziz · European journal of case reports in internal medicine · 2021 · DOI
This case report describes a young woman who developed an unusual combination of liver problems, destruction of red blood cells, and an enlarged spleen—all caused by reactivation of Epstein-Barr virus (EBV), the virus behind infectious mononucleosis. The case highlights that EBV can cause rare and complex symptoms affecting multiple body systems, and doctors should test for EBV early when patients have these types of multi-system problems rather than jumping to expensive or invasive tests.
Many ME/CFS patients report EBV reactivation or persistent EBV infection as a potential trigger or contributor to their condition. This case demonstrates that EBV can cause complex, multisystem manifestations involving hematologic, hepatic, and immunologic dysfunction—findings relevant to understanding the diverse pathophysiology potentially underlying ME/CFS. Recognition of EBV's broad clinical spectrum may help clinicians better evaluate and manage post-viral fatigue syndromes.
This single case report does not establish how common these EBV complications are, whether they progress to ME/CFS, or the mechanisms linking EBV reactivation to chronic fatigue. The case describes acute presentation; it does not clarify the relationship between acute EBV illness and long-term chronic conditions. Association with EBV does not prove causation of subsequent ME/CFS development.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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