Epstein-Barr virus-associated cholestatic hepatitis

• Author(s): Salva, I ; Silva, IV ; Cunha, F
• Date: 2013
• Persistent ID: http://hdl.handle.net/10400.26/5812
• Origin: Hospital de Vila Franca de Xira
• Subject(s): Epstein-Barr Virus Infections; Cholestasis, Intrahepatic
• Document Type: Journal article
• Language: English
• Contributor(s): Repositório Comum

Description

Epstein-Barr virus infection is common in children, usually presenting as infectious mononucleosis, including fever, tonsillitis and lymphadenopathy associated with self-resolving increase in transaminases. Cholestasis is rare in children with only a few cases reported but it was described in up to 55% of the adult population affected. We present a case of a 6-year-old boy with fever, vomiting and choluria. The physical examination showed hepatomegaly and jaundice and was otherwise unremarkable. The laboratory studies revealed increased transaminases (aspartate aminotransferase 97 U/L, alanine aminotransferase 166 U/L), hyperbilirubinaemia (total bilirubin 3.2 mg/dL, direct bilirubin 2.89 mg/dL) and increased γ-glutamyl transpeptidase (114 mg/dL). Urine urobilinogen was increased. The abdominal ultrasound showed hepatomegaly. Epstein-Barr viral capsid antibody IgM was positive and IgG was negative. Serological studies for other viruses were negative. We underline the need to consider Epstein-Barr virus in the cholestatic hepatitis differential diagnosis, in order to avoid unnecessary investigations.