Unusual Presentation of Epstein-Barr Virus-Associated Cholestatic Hepatitis in an Infant.

Autor: Jadah RHS; From the Department of Paediatrics, Bahrain Defence Force Royal Medical Services, Riffa, Bahrain., Shaikho NMG; From the Department of Paediatrics, Bahrain Defence Force Royal Medical Services, Riffa, Bahrain., Hasan SA; From the Department of Paediatrics, Bahrain Defence Force Royal Medical Services, Riffa, Bahrain.
Jazyk: angličtina
Zdroj: JPGN reports [JPGN Rep] 2021 Jun 15; Vol. 2 (3), pp. e089. Date of Electronic Publication: 2021 Jun 15 (Print Publication: 2021).
DOI: 10.1097/PG9.0000000000000089
Abstrakt: Epstein-Barr virus (EBV) infections are prevalent in the pediatric population but are subclinical in the majority of cases. Elevated transaminases in the acute setting rarely increase beyond 5 times the normal upper limit. We present a girl aged 1 y with fever, vomiting, and diarrhea. Although initial physical examination was unremarkable, she developed jaundice, hepatomegaly, abdominal distension, and a maculopapular rash during admission. Laboratory investigations revealed marked increase in transaminases (alanine aminotransferase 7,664.5 IU/L, aspartate aminotransferase 12,266 IU/L), elevated γ-glutamyl transferase (224 IU/L), and hyperbilirubinemia (total 130.7 µmol/L, direct 104.9 µmol/L). Abdominal ultrasound reported hepatomegaly with mild ascites. Serology revealed that both Monospot test and EBV immunoglobulin G were positive. With supportive therapy, improvement was noted within a week of symptom onset. We hereby elucidate the importance of considering EBV as a cause of acute cholestatic hepatitis in a very young pediatric patient who develops a rapid elevation of liver enzymes.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2021 The Author(s). Published by Wolters Kluwer on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
Databáze: MEDLINE
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