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Epstein-Barr virus-associated cholestatic hepatitis

Inês Salva1, Inês Vaz Silva, Florbela Cunha

  • 1Department of Pediatrics, Hospital de Dona Estefânia, Lisbon, Portugal.

BMJ Case Reports
|December 18, 2013
PubMed

Insights

Epstein-Barr virus can cause cholestatic hepatitis in children, a rare but serious condition. Early consideration of EBV is crucial for accurate diagnosis and avoiding unnecessary tests.

Area of Science:

  • Pediatric Gastroenterology
  • Viral Hepatitis
  • Infectious Diseases

Background:

  • Epstein-Barr virus (EBV) commonly causes infectious mononucleosis in children, typically with mild hepatitis.
  • Cholestasis is an uncommon presentation of EBV infection in pediatric populations, unlike in adults where it is more frequent.

Observation:

  • A 6-year-old boy presented with fever, vomiting, choluria, hepatomegaly, and jaundice.
  • Laboratory results indicated elevated transaminases, hyperbilirubinemia with direct hyperbilirubinemia, and increased gamma-glutamyl transpeptidase, suggestive of cholestasis.
  • Abdominal ultrasound revealed hepatomegaly, and serological tests confirmed acute Epstein-Barr virus infection.

Findings:

  • The case highlights a rare presentation of Epstein-Barr virus infection manifesting as cholestatic hepatitis in a pediatric patient.
  • Diagnostic workup excluded other viral etiologies, strengthening the association with EBV.

Implications:

  • This case underscores the importance of including Epstein-Barr virus in the differential diagnosis for pediatric cholestatic hepatitis.
  • Prompt recognition of EBV-induced cholestasis can prevent extensive and potentially unnecessary investigations for other causes of liver dysfunction.

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