A case of cholestatic hepatitis by Epstein-Barr virus infection / 대한내과학회지

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.