Clinical Characteristics of Primary Epstein Barr Virus Hepatitis with Elevation of Alkaline Phosphatase and γ-Glutamyltransferase in Children

Abstract

PurposeThe 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.Materials and MethodsA 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).ResultsThe 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.ConclusionPrimary 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.

Analysis Of Clinical, Haematological And Biochemical Parameters In Patients With Infectious Mononucleosis

“…In cases when there are no clinical signs of liver damage, there is always a characteristic histopathological change (6,8,12). Consistent with those studies, our results are similar in that the liver enzymes were increased.…”

“…Our data showed that the AST and ALT levels were elevated approximately 5-fold above the normal limits, a finding that is consistent with the existing literature (6,14,15). Elevations greater than 10-fold over the normal levels are less likely (16), but our results have shown that the AST levels in 3.9% of patients and ALT levels in 9.8% of patients were greater than 10-fold the normal levels, which correlates with the results of Yang et al (12). The incidence of serum ALT levels greater than 1000 IU/L was similar to the result of a previous study (17).…”

“…Ukoliko se primarna infekcija odigra u adolescentnom ili odraslom dobu, najčešće se klinički prezentuje kao infektivna mononukleoza, u vidu povišene telesne temperature, limfadenopatije i angine. Naša retrospektivna studija je obuhvatila 51 pacijenta prosečne starosti 17 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) …”

Hepatic Involvement in Epstein-Barr Virus and Cytomegalovirus Infections: Evaluation of 31 Cases

“…primer EBV enfeksiyonu ile birlikte hepatit gelişen 36 hastayı değerlendirdikleri retrospektif çalışmada, ateş yüksekliğini %83, servikal lenfadenopati %77,8, hepatomegali %30,6 ve splenomegaliyi %27,8 olarak bulmuşlar, ikterik hepatit tablosunda olan iki hasta (%5,6) bildirmişlerdir. 14 Klinik yakınma ve bulgular deerlendirildiğinde ça-lışmamızda benzer sonuçlar elde edilmiş olup, ikterik hepatit % 6,5 oranında görülmüştür.…”

Герпесвірусний Гепатит 6-Го Типу У Дитини Раннього Віку

“…Наибольшее число исследований по проблеме герпесвирусных гепатитов посвящено цитомега-ловирусным (ЦМВ) и гепатитам, обусловленным вирусом Эпштейна -Барр [2,3,[6][7][8]. В послед-ние годы приводятся данные о поражении пече-ни, вызванные вирусами герпеса человека 6-го типа (ВГЧ-6), с возможностью развития хрони-ческого гепатита и формирования цирроза пече-ни [2,3,9,10].…”