Is EBV a Common Cause of Elevated Liver Enzymes?
Discussion
Infectious mononucleosis is caused by an Epstein-Barr Virus (EBV) infection causing the triad of fever, sore throat and adenopathy.
The differential diagnosis of clinical presentations similar to EBV includes:
Viral
Cytomegalovirus
Herpes simplex
Hepatitis A, B, C
HIV
Varicella
Bacterial/Spirochete
Brucellosis
Leptospirosis
Syphilis
Q fever
Miscellaneous
Autoimmune hepatitis
Drug side effects
Ischemia
Wilson Disease
Treatment for EBV infections is mainly supportive. Anti-viral medications such as ganciclovir are usually used for severe problems. Liver failure has been treated by transplant.
Refraining from activities which could cause abdominal trauma while splenomegaly is apparent is recommended as is medications that are hepatotoxic until liver function tests normalize.
Learning Point
EBV infections are usually asymptomatic with 90-95% of people by age 18 becoming seropositive.
EBV is known have many different clinical presentations which can be reviewed here.
A monospot test for EBV can be falsely positive and reasons for this can be reviewed here.
Gastrointestinal problems related to EBV include:
Mildly elevated transaminase levels (2-3x normal) that are asymptomatic clinically
Laboratory test abnormalities
Alkaline phosphatase – 60%
Bilirubin – 45%
Mild abdominal pain – 15%
Jaundice – < 5 %
Hepatitis (with moderate 5-10 x transaminase elevation) – 80-90%
Hepatosplenomegaly 6-14%
Splenomegaly 50-60%
Splenic rupture
L...
Source: PediatricEducation.org - Category: Pediatrics Authors: Donna M. D'Alessandro, M.D. Tags: Uncategorized Source Type: news
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