Yonsei Med J.  2014 Jan;55(1):107-112. 10.3349/ymj.2014.55.1.107.

Clinical Characteristics of Primary Epstein Barr Virus Hepatitis with Elevation of Alkaline Phosphatase and gamma-Glutamyltransferase in Children

• Yang SI
• Geong JH
• Kim JY

• KMID: 1779893
• DOI: http://doi.org/10.3349/ymj.2014.55.1.107

Abstract

PURPOSE
The aim of the present study was to evaluate the clinical characteristics of the primary Epstein-Barr virus (EBV) hepatitis with elevation of both serum alkaline phosphatase (ALP) and gamma-glutamyltransferase (gamma-GT) levels in children.
MATERIALS AND METHODS
A retrospective study was performed by reviewing of the medical records of 36 patients who were diagnosed with primary EBV hepatitis. The patients were divided into 2 groups: patients with elevated serum ALP and gamma-GT levels (group 1) and patients without (group 2).
RESULTS
The classic features of infectious mononucleosis (fever, pharyngitis and/or tonsillitis, and cervical lymphadenitis) were seen in 20 (57.1%) of group 1 patients and 18 (50.0%) of group 2 patients. Hepatitis with elevated serum ALP and gamma-GT levels were present in 14 (38.9%) of the all patients. Of these patients, Jaundice occurred in only 2 (5.6%). The mean levels of aspartate aminotransferase and alanine aminotransferase (ALT) as well as the number of patients with ALT greater than 400 IU/L were significantly different between the groups (177 IU/L vs. 94 IU/L, 418 IU/L vs. 115 IU/L, and 50.0% vs. 13.6%; p=0.001, p=0.001, p=0.026, respectively). The mean duration of elevated serum ALT levels was 17.5 days in group 1 and 9.0 days in group 2 (p=0.013). All patients recovered fully without any chronic or serious complications.
CONCLUSION
Primary EBV hepatitis with predominant biochemical abnormalities of the elevation of ALP and gamma-GT is frequent and mostly anicteric. This may represent a benign disease, but a delay in recovery of liver function as well.

Keyword

Primary Epstein-Barr virus hepatitis; alkaline phosphatase; gamma-glutamyltransferase; children

MeSH Terms

Alkaline Phosphatase/genetics/*metabolism
Child
Child, Preschool
Female
Hepatitis/*enzymology/*pathology/virology
Herpesvirus 4, Human/*pathogenicity
Humans
Infant
Male
gamma-Glutamyltransferase/genetics/*metabolism
Alkaline Phosphatase
gamma-Glutamyltransferase

Figure

• 

  Fig. 1 Enrollment of patients. EBV, Epstein-Barr virus; ALT, alanine aminotransferase; anti-EBNA, EB nuclear antigen; CMV, cytomegalovirus.

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  Fig. 2 Age distribution of 36 patients with primary EBV hepatitis. EBV, Epstein-Barr virus.

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