Edoute Y, Baruch Y, Lachter J, Furman E, Bassan L, Assy N
Department of Internal Medicine C, Rambam Medical Centre and The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.
J Gastroenterol Hepatol. 1998 Aug;13(8):821-4. doi: 10.1111/j.1440-1746.1998.tb00739.x.
Infectious mononucleosis due to Epstein-Barr virus (EBV) is almost always a self-limited disease, most commonly seen in young adults. Hepatitis is a well-recognized complication of EBV infection that usually resolves spontaneously. Jaundice occasionally results from the unusual complication of autoimmune haemolytic anaemia rather than hepatitis. We report a 60-year-old man with severe cholestatic jaundice whose history, liver histology and laboratory findings suggested EBV infection. He also developed significant jaundice related to his hepatitis, but not to autoimmune haemolysis, a situation that led to diagnostic delay. Costly diagnostic laboratory tests and invasive procedures were performed to rule out a malignant extrahepatic biliary obstruction. Physicians need to be aware of this complication and EBV infection should be included in the differential diagnosis of cholestatic jaundice in the elderly.
由爱泼斯坦-巴尔病毒（EBV）引起的传染性单核细胞增多症几乎总是一种自限性疾病，最常见于年轻人。肝炎是EBV感染一种公认的并发症，通常会自发缓解。黄疸偶尔是由自身免疫性溶血性贫血这一罕见并发症导致的，而非肝炎。我们报告一名60岁男性，患有严重胆汁淤积性黄疸，其病史、肝脏组织学和实验室检查结果提示EBV感染。他还出现了与肝炎相关的明显黄疸，但与自身免疫性溶血无关，这种情况导致了诊断延迟。为排除恶性肝外胆管梗阻进行了昂贵的诊断性实验室检查和侵入性操作。医生需要意识到这种并发症，在老年人胆汁淤积性黄疸的鉴别诊断中应考虑EBV感染。
