Korean J Med.  2008 Mar;74(3):305-309.

A case of cholestatic hepatitis by Epstein-Barr virus infection

• Kim JI
• Kang SY
• Jung JH
• Kim SH
• Lee BS
• Lee HY
• Kang DY

Abstract

Epstein-Barr virus (EBV) is a rare causative agent of acute hepatitis during the course of infectious mononucleosis. EBV-associated hepatitis is usually mild and it resolves without serious complications. Clinically long-standing jaundice with a high bilirubin level (greater than 6.0 mg/dL and longer than 6 weeks) is extremely rare. We recently experienced a-16-yr-old man with long-standing severe jaundice (peak: 21 mg/dL, duration: 16weeks) that was caused by EBV in the absence of any other common features of infectious mononucleosis. EBV infection was demonstrated by serologic testing that showed positive IgM anti-EBV VCA (viral capsid antigen). We also confirmed that the liver was the primary site of EBV infection by in situ hybridization, which was performed on the liver tissues. The patient recovered completely without complications after 16 weeks with only supportive care. We report here on this case along with a literature review. EBV-associated hepatitis can occur with severe long-standing hyperbilirubinemia as an unusual manifestation.

Keyword

Epstein-Barr virus; Hepatitis; Jaundice

MeSH Terms

Bilirubin
Capsid
Epstein-Barr Virus Infections
Hepatitis
Herpesvirus 4, Human
Humans
Hyperbilirubinemia
Immunoglobulin M
In Situ Hybridization
Infectious Mononucleosis
Jaundice
Liver
Serologic Tests
Viruses
Bilirubin
Immunoglobulin M