Kang Seok-Jin, Yoon Ka-Hyun, Hwang Jin-Bok
Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2013 Mar;16(1):61-4. doi: 10.5223/pghn.2013.16.1.61. Epub 2013 Mar 31.
Infection-induced acute hepatitis complicated with acute pancreatitis is associated with hepatitis A virus, hepatitis B virus or hepatitis E virus. Although rare, Epstein-Barr virus (EBV) infection should be considered also in the differential diagnosis if the patient has acute hepatitis combined with pancreatitis. We report a case of EBV infection with cholestatic hepatitis and pancreatitis with review of literature. An 11-year-old female was admitted due to 1-day history of abdominal pain and vomiting without any clinical symptoms of infectious mononucleosis. Diagnosis of reactivated EBV infection was made by the positive result of viral capsid antigen (VCA) IgM, VCA IgG, Epstein-Barr nuclear antigen and heterophile antibody test. We performed serologic tests and magnetic resonance cholangiopancreatography to exclude other viral or bacterial infection, autoimmune disorder, and structural problems. The patient's symptoms recovered rapidly and blood chemistry returned to normal with conservative treatment similar to previously reported cases.
感染性急性肝炎合并急性胰腺炎与甲型肝炎病毒、乙型肝炎病毒或戊型肝炎病毒有关。虽然罕见，但如果患者出现急性肝炎合并胰腺炎，在鉴别诊断中也应考虑爱泼斯坦-巴尔病毒（EBV）感染。我们报告一例EBV感染合并胆汁淤积性肝炎和胰腺炎的病例并复习文献。一名11岁女性因1天的腹痛和呕吐病史入院，无任何传染性单核细胞增多症的临床症状。通过病毒衣壳抗原（VCA）IgM、VCA IgG、爱泼斯坦-巴尔核抗原和嗜异性抗体检测结果呈阳性，诊断为EBV再激活感染。我们进行了血清学检测和磁共振胰胆管造影，以排除其他病毒或细菌感染、自身免疫性疾病和结构问题。与先前报道的病例相似，经保守治疗，患者症状迅速恢复，血液生化指标恢复正常。
