Prolonged hepatitis and jaundice: a rare complication of paediatric Epstein-Barr virus infection

We herein report the case of a 14-year-old girl with Epstein-Barr virus (EBV) infectious mononucleosis who developed prolonged hepatitis and jaundice. At presentation, she had tender hepatomegaly with a markedly deranged liver function test. Abdominal ultrasonography showed hepatomegaly and a thicke...

Full description

Saved in:
Bibliographic Details
Published in:Singapore medical journal 2015-07, Vol.56 (7), p.e112-e115
Main Authors: Tan, Zhen Han, Phua, Kong Boo, Ong, Christina, Kader, Ajmal
Format: Article
Language:English
Subjects:
Adolescent
Alanine Transaminase - blood
Antiviral Agents - therapeutic use
Bilirubin - blood
Case Report
China
Epstein-Barr Virus Infections - complications
Female
Gallbladder - pathology
gamma-Glutamyltransferase - blood
Hepatitis - complications
Hepatomegaly - complications
Humans
Immunosuppressive Agents - therapeutic use
Jaundice - complications
Liver - diagnostic imaging
Treatment Outcome
Ultrasonography
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We herein report the case of a 14-year-old girl with Epstein-Barr virus (EBV) infectious mononucleosis who developed prolonged hepatitis and jaundice. At presentation, she had tender hepatomegaly with a markedly deranged liver function test. Abdominal ultrasonography showed hepatomegaly and a thickened gallbladder wall. During the subsequent 11 weeks, her transaminases showed two further peaks, which corresponded with clinical deterioration. Her highest alanine transaminase level was 1,795 µ/L and total bilirubin level was 154 µmol/L. She recovered fully with conservative management. EBV-related liver involvement is typically mild and self-limiting. We believe that tender hepatomegaly and gallbladder thickening may be important predictors of significant liver involvement. Although multiple transaminase peaks may occur, we do not consider this an indication for antiviral or immunosuppressive therapy. In the absence of strong evidence supporting the use of any specific therapy, we recommend a conservative approach for an immunocompetent patient.
ISSN:0037-5675
DOI:10.11622/smedj.2015113