Open AccessUnusual Presentation of Epstein‐Barr Virus‐Associated Cholestatic Hepatitis in an Infant
Author(s) -
Jadah Raafat Hammad Seroor,
Shaikho Noor Mohamed Ghassan,
Hasan Sara Abdulla
Publication year - 2021
Publication title -
jpgn reports
Language(s) - English
Resource type - Journals
ISSN - 2691-171X
DOI - 10.1097/pg9.0000000000000089
Subject(s) - medicine , gastroenterology , jaundice , maculopapular rash , elevated transaminases , subclinical infection , vomiting , abdominal distension , hepatitis , population , rash , pediatrics , environmental health
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.