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: Tags: Uncategorized Source Type: news