Acute Cholestatic Hepatitis Induced by Epstein-Barr virus (EBV) Infection in a Child: A Case Report

Main Article Content

Chanakan Tanjararak

Abstract

        Primary Epstein-Barr virus (EBV) infection occurs frequently in children and causes various clinical manifestations. The patients may be asymptomatic and spontaneously recover from infection or has severe symptoms with fatal complication. The frequent manifestations include fever, exudative pharyngotonsillitis, and lymphadenopathy. EBV infection leads to mild and selflimited increase in liver enzymes. However, clinical manifestations of hepatitis including jaundice are very rare in children, with only several cases previously reported in the medical literature.


       We report a case of an 11 years 8 months old girl who was hospitalized because of cholestatic hepatitis induced by EBV infection.


        EBV infection should be considered in the differential diagnosis of cholestatic hepatitis in children, in order to avoid unnecessary investigations.

Downloads

Download data is not yet available.

Article Details

Section
Case Report

References

Noor A, Panwala A, Forouhar F, Wu GY. Hepatitis caused by herpes viruses: a review. J Dig Dis 2018;19(8):446-55.

Hidnedi TB, Koff RS. Cholestatic hepatitis induced by Epstein-Barr virus infection in an adult. Dig Dis Sci 2003;48(3):539-41.

Kim YJ. Viral hepatitis accompanying fever caused by non-hepatitis viruses. Postgraduate Course 2011:137-45.

Pashankar D, Schreiber RA. Jaundice in older children and adolescents. Pediatr Rev 2001;22(7):219-26.

Brumbaugh D, Mack C. Conjugated hyperbilirubinemia in children. Pediatr Rev 2012;33(7):291-302.

Yang SI, Geong JH, Kim JY. Clinical characteristics of primary Epstein-Barr virus hepatitis with elevation of alkaline phosphatase and γ-glutamyltransferase in children. Yonsei Med J 2014;55(1):107-12.

Guimaraes C, Garrido R, Chaves M, Martins S. Cholestatic hepatitis: atypical presentation of Epstein-Barr virus infection. JPNIM 2018;7(1);e070118. doi:10.7363/070118.

Kofteridis DP, Koulentaki M, Valachis A, Christofaki M, Mazokopakis E, Papazoglou G, et al. Epstein- Barr virus hepatitis. Eur J Intern Med 2011;22(1):73-6.

Salva I, Silva IV, Cunha F. Epstein-Barr virusassociated cholestatic hepatitis. BMJ Case Rep 2013;2013:bcr2013202213.

Axelrod P, Finestone AJ. Infectious mononucleosis in older adults. Am Fam Physician 1990;42(6):1599-606.

Sanchez NM, Dominguez CA, Chavez-Tapia NC, Uribe M. Hepatic manifestations of Epstein-Barr viral infection. Ann Hepatol 2005;4(3):205-9.

Zemer VS, Nissan KS, Hoffnung LA, Amir J, Bilavsky E. Cholestatic hepatitis induced by Ebstein-Barr virus in a pediatric population. Clin Pediatr 2015;54(12):1153-7.

Khoo A. Acute cholestatic hepatitis induced by Epstein-Barr virus infection in an adult: a case report. J Clin Med Case Rep 2016;10:75. doi:10.1186/s13256-016-8059-x.