Acute gastritis associated with Epstein-Barr virus infection in a child

  • Kim, Ji Mok (Department of Pediatrics, Chungnam National University School of Medicine) ;
  • Song, Chun Woo (Department of Pediatrics, Chungnam National University School of Medicine) ;
  • Song, Kyu Sang (Department of Pathology, Chungnam National University School of Medicine) ;
  • Kim, Jae Young (Department of Pediatircs, Changwon Gyeosang National University Hospital)
  • Received : 2015.09.15
  • Accepted : 2015.10.28
  • Published : 2016.11.15


Infectious mononucleosis is Epstein-Barr virus (EBV) inducing a self-limiting clinical syndrome characterized by fever, sore throat, hepatosplenomegaly, and generalized lymphadenopathy. Gastrointestinal symptoms of EBV infection are nonspecific and occur rarely. EBV inducing acute gastrointestinal pathology is poorly recognized without suspicion. Careful consideration is needed to diagnose gastric involvement of EBV infection including gastric lymphoma, gastric cancer, and gastritis. A few recent cases of gastritis associated with EBV infection have been reported in adolescents and adults. However, there is no report of EBV-associated gastritis in early childhood. We experienced a rare case of 4-year-old girl with EBV gastritis confirmed by in situ hybridization.


  1. Zhang Y, Molot R. Severe gastritis secondary to Epstein-Barr viral infection. Unusual presentation of infectious mononucleosis and associated diffuse lymphoid hyperplasia in gastric mucosa. Arch Pathol Lab Med 2003;127:478-80.
  2. Rea TD, Russo JE, Katon W, Ashley RL, Buchwald DS. Prospective study of the natural history of infectious mononucleosis caused by Epstein-Barr virus. J Am Board Fam Pract 2001;14:234-42.
  3. Markin RS. Manifestations of Epstein-Barr virus-associated disorders in liver. Liver 1994;14:1-13.
  4. Owens SR, Walls A, Krasinskas AM, Rund CR. Epstein-Barr virus gastritis: rare or rarely sampled? A case report. Int J Surg Pathol 2011;19:196-8.
  5. Chen ZM, Shah R, Zuckerman GR, Wang HL. Epstein-Barr virus gastritis: an underrecognized form of severe gastritis simulating gastric lymphoma. Am J Surg Pathol 2007;31:1446-51.
  6. Kitayama Y, Honda S, Sugimura H. Epstein-Barr virus-related gastric pseudolymphoma in infectious mononucleosis. Gastrointest Endosc 2000;52:290-1.
  7. Sujino T, Ebinuma H, Hosoe N, Okamoto S, Imaeda H, Hayashi Y, et al. Epstein-barr virus-associated gastritis: a case report. Dig Dis Sci 2013;58:883-6.
  8. Hisamatsu A, Nagai T, Okawara H, Nakashima H, Tasaki T, Nakagawa Y, et al. Gastritis associated with Epstein-Barr virus infection. Intern Med 2010;49:2101-5.
  9. Yanai H, Takada K, Shimizu N, Mizugaki Y, Tada M, Okita K. Epstein-Barr virus infection in non-carcinomatous gastric epithelium. J Pathol 1997;183:293-8.<293::AID-PATH937>3.0.CO;2-C
  10. Epstein MA, Achong BG. Pathogenesis of infectious mononucleosis. Lancet 1977;2:1270-3.
  11. Ueo T, Kashima K, Daa T, Kondo Y, Yokoyama S. Coexistence of Epstein-Barr virus-associated gastric carcinoma with malignant lymphoma: report of two cases. Virchows Arch 2006;449:215-9.
  12. Thorley-Lawson DA, Gross A. Persistence of the Epstein-Barr virus and the origins of associated lymphomas. N Engl J Med 2004;350:1328-37.
  13. Mori M, Watanabe M, Tanaka S, Mimori K, Kuwano H, Sugimachi K. Epstein-Barr virus-associated carcinomas of the esophagus and stomach. Arch Pathol Lab Med 1994;118:998-1001.
  14. Whitelaw F, Brook MG, Kennedy N, Weir WR. Haemolytic anaemia complicating Epstein-Barr virus infection. Br J Clin Pract 1995;49:212-3.
  15. Corssmit EP, Leverstein-van Hall MA, Portegies P, Bakker P. Severe neurological complications in association with Epstein-Barr virus infection. J Neurovirol 1997;3:460-4.