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Open Access Research

Detection of Epstein Barr Virus by Chromogenic In Situ Hybridization in cases of extra-hepatic biliary atresia

Fatemeh Mahjoub1*, Reza Shahsiah2, Farid Azmoudeh Ardalan2, Guiti Iravanloo2, Mehri Najafi Sani3, Abdolmajid Zarei2, Maryam Monajemzadeh1, Fatemeh Farahmand3 and Setareh Mamishi4

Author affiliations

1 Pathology Department, Markaze Tebbi Koodakan (Children Hospital related to Tehran University of Medical Sciences), End of Keshavarz Boulevard, Tehran, Iran

2 Department of Pathology and Laboratory Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Gastro – Enterology, Markaze Tebbi Koodakan (Children Hospital related to Tehran University of Medical Sciences), End of Keshavarz Boulevard, Tehran, Iran

4 Infectious Disease Research Center, Markaze Tebbi Koodakan (Children Hospital related to Tehran University of Medical Sciences), End of Keshavarz Boulevard, Tehran, Iran

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Citation and License

Diagnostic Pathology 2008, 3:19  doi:10.1186/1746-1596-3-19

Published: 28 April 2008

Abstract

Introduction

Extra-hepatic biliary atresia (EHBA) is an important cause of neonatal cholestasis. Several infectious agents have been proposed as etiologic factors such as Rotavirus and Reovirus. There is limited data on the role of Epstein Barr virus (EBV) infection in EHBA, so we decided to study the presence of EBV virus in a series of 16 proven EHBA cases by Chromogenic in situ hybridization (CISH) technique.

Methods

In the current study a total of 16 liver wedge biopsies of proven cases of EHBA were selected in a period of 4 years. CISH staining for EBV-encoded RNA (EBER) transcript was performed.

Results

The review of H&E-stained slides of liver biopsies revealed fibrosis and marked ductular proliferation. In CISH-stained slides, EBV trace was observed in hepatocytes in two cases and in biliary epithelium in one case of EHBA.

Discussion

Considering the association of hepatitis with the Epstein-Barr virus in later life, it is likely that EBV hepatitis and its complications occur in the neonatal/perinatal period. Since EHBA is a relatively rare disease, a similar study on wedge biopsies of this number of proven cases of EHBA has not been performed to date. Current observation proposes the need for a study of larger series and employing other methods for confirming the etiologic role of EBV in EHBA cases.