Fulminant liver failure due to Epstein-Barr virus in immunodeficiency disorders
Bibliographic record
Abstract
Background: The majority of patients with Epstein-Barr virus (EBV)-associated hepatitis have a mild clinical course; most infections resolve spontaneously. However, in rare cases, or in patients with underlying immune deficits, outcomes can be fatal. Methods: We used a single-centre case series. Results: In this report, we describe two cases of acute EBV hepatitis. The first patient developed fulminant hepatitis with multi-organ failure and severe immune dysregulation; he died despite maximal intensive-care management. Post-mortem, his bone marrow biopsy results revealed an X-linked lymphoproliferative disease. This primary immunodeficiency impairs the body's ability to control EBV infection and is a risk factor for developing an EBV-positive T-cell lymphoma in childhood. The second patient presented with hepatitis, cytopenias, and hepatosplenomegaly in the context of persistent EBV viremia and responded well to treatment (dexamethasone, rituximab, and supportive care). Immunodeficiency testing was negative in this case. Conclusions: Prompt multidisciplinary management is recommended in cases of severe EBV-associated liver injury.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".