El Khatib Hassan, Kawtharany Batoul, Mohammad Diyaa, Siblini Mohammad, El-Rifai Nahida
Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon.
Department of Surgery, Makassed General Hospital, Beirut, Lebanon.
Case Rep Pediatr. 2019 Jan 29;2019:7320109. doi: 10.1155/2019/7320109. eCollection 2019.
Hepatic involvement is common in acute Epstein-Barr virus (EBV) infection in children. It usually manifests as a transitory elevation of transaminases in up to 80% to 90% of patients, and they normalize by 2 to 6 weeks. A cholestatic pattern with elevated gamma-glutamyl transferase (GT) and alkaline phosphatase (ALP) is common, in up to 60% in young adults. However, jaundice is very rare occurring in only 5% of pediatric patients. We report here an 8-month-old female with EBV infection who developed obstructive jaundice 2 weeks after the initial infection. Radiologic investigations were compatible with choledochal cyst type IVa complicated by stone formation in the common bile duct. In case of clinical exacerbation or nonamelioration of liver function tests in EVB infection, another diagnosis should be addressed. This highlights the importance of close follow-up in these patients in order not to miss a serious underlying condition such as choledochal malformation.
肝脏受累在儿童急性爱泼斯坦-巴尔病毒（EBV）感染中很常见。在高达80%至90%的患者中，它通常表现为转氨酶短暂升高，且转氨酶在2至6周内恢复正常。伴有γ-谷氨酰转移酶（GT）和碱性磷酸酶（ALP）升高的胆汁淤积型很常见，在年轻成年人中高达60%。然而，黄疸非常罕见，仅在5%的儿科患者中出现。我们在此报告一名8个月大的感染EBV的女性，在初次感染后2周出现梗阻性黄疸。影像学检查结果与IVa型胆总管囊肿合并胆总管结石形成相符。在EBV感染时，如果临床症状加重或肝功能检查无改善，应考虑其他诊断。这突出了对这些患者进行密切随访的重要性，以免漏诊诸如胆总管畸形等严重的潜在疾病。
