Infectious Mononucleosis Presenting with Cholestatic Liver Disease
Authors: Charles N. Bernstein
Journal: Annals of Internal Medicine (1998)

Letters15 March 1998Infectious Mononucleosis Presenting with Cholestatic Liver DiseaseCharles N. Bernstein, MD and Gerald Y. Minuk, MDCharles N. Bernstein, MDUniversity of Manitoba; Winnipeg, Manitoba R3A1R9, CanadaSearch for more papers by this author and Gerald Y. Minuk, MDUniversity of Manitoba; Winnipeg, Manitoba R3A1R9, CanadaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-6-199803150-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although Epstein-Barr virus (EBV) is not a hepatotrophic virus, hepatomegaly (10%) and mild liver enzyme abnormalities (40%) are not uncommon in patients with EBV infection [1]. Typically, the enzyme abnormalities are consistent with hepatocellular liver injury (hepatitis) rather than decreased bile flow (cholestasis) [1]. We report on two patients with acute infectious mononucleosis secondary to EBV infection whose predominant biochemical abnormalities were marked elevations in serum levels of alkaline phosphatase.A 22-year-old woman working at a summer camp where three other campers had infectious mononucleosis developed lethargy, fever (body temperature, 102 °F), and sore throat that lasted ...References1. Rapp CE, Hewetson JF. Infectious mononucleosis and the Epstein-Barr virus. Am J Dis Child. 1978; 132:78-86. Google Scholar2. Shuster F, Ognibene AJ. Dissociation of serum bilirubin and alkaline phosphatase in infectious mononucleosis. JAMA. 1969; 209:267-8. Google Scholar3. Lefkowitch JH, Schiff ER, Davis GL, Perrillo RP, Lindsay K, Bodenheimer HC Jr, et al. Pathological diagnosis of chronic hepatitis C: a multicentre comparative study with chronic hepatitis B. Gastroenterology. 1993; 104:595-603. Google Scholar4. Patti MA, Selvaggi KJ, Kroboth FJ. Varicella hepatitis in the immunocompromised adult: a case report and review of the literature. Am J Med. 1990; 88:77-80. Google Scholar5. Biest S, Schubert TT. Chronic Epstein-Barr virus infection: a cause of granulomatous hepatitis? J Clin Gastroenterol. 1989; 11:343-6. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Manitoba; Winnipeg, Manitoba R3A1R9, Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByEpstein–Barr virus‐induced sickle hepatopathyHepatic Manifestations of Nonhepatotropic Infectious Agents Including Severe Acute Respiratory Syndrome Coronavirus-2, Adenovirus, Herpes Simplex Virus, and Coxiella burnetiiHepatitis caused by herpes viruses: A reviewEpstein-barr virus associated acute hepatitis with cross-reacting antibodies to other herpes viruses in immunocompetent patients: Report of two casesDIFFERENTIAL CLINICAL PRESENTATIONS OF EPSTEIN-BARR VIRUS INFECTION AND A BRIEF LITERATURE REVIEWEpstein Barr Virus hepatitisCholestatic Variants of Viral Disease and AlcoholHepatic manifestations of Epstein-Barr viral infectionLethal liver failure in an elderly patient with hepatitis B superinfected with Epstein–Barr virusEpstein–Barr virus infection mimicking extrahepatic biliary obstruction 15 March 1998Volume 128, Issue 6Page: 509KeywordsEnzymesEpithelial cellsEpstein-Barr virusFeversHepatitis AHepatosplenomegalyInfectious diseasesLiverLiver diseasesPhosphatases Issue Published: 15 March 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...