Department of Pediatrics, School of Medicine, Chungnam National University, 282 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea.
Yonsei Med J. 2014 Jan;55(1):107-12. doi: 10.3349/ymj.2014.55.1.107.
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 γ-glutamyltransferase (γ-GT) levels in children.
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 γ-GT levels (group 1) and patients without (group 2).
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 γ-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.
Primary EBV hepatitis with predominant biochemical abnormalities of the elevation of ALP and γ-GT is frequent and mostly anicteric. This may represent a benign disease, but a delay in recovery of liver function as well.
本研究旨在评估血清碱性磷酸酶（ALP）和γ-谷氨酰转移酶（γ-GT）水平同时升高的儿童原发性 EBV 肝炎的临床特征。
通过回顾性分析诊断为原发性 EBV 肝炎的 36 例患者的病历资料进行研究。将患者分为两组：血清 ALP 和 γ-GT 水平升高的患者（组 1）和未升高的患者（组 2）。
组 1 患者中有 20 例（57.1%）出现了传染性单核细胞增多症的典型特征（发热、咽炎和/或扁桃体炎和颈部淋巴结炎），组 2 患者中有 18 例（50.0%）出现了上述特征。所有患者中有 14 例（38.9%）出现了伴有血清 ALP 和 γ-GT 水平升高的肝炎。这些患者中仅有 2 例（5.6%）出现了黄疸。两组患者的天冬氨酸氨基转移酶（AST）和丙氨酸氨基转移酶（ALT）的平均水平以及 ALT 大于 400IU/L 的患者比例均有显著差异（177IU/L 比 94IU/L，418IU/L 比 115IU/L，50.0% 比 13.6%；p=0.001，p=0.001，p=0.026）。组 1 患者 ALT 水平升高的平均持续时间为 17.5 天，组 2 为 9.0 天（p=0.013）。所有患者均完全康复，无任何慢性或严重并发症。
以 ALP 和 γ-GT 升高为主的原发性 EBV 肝炎较为常见，且多为无黄疸型。这可能代表一种良性疾病，但也可能存在肝功能恢复延迟的情况。
