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• W2977328009 abstract "Introduction: Epstein-Barr virus (EBV) is a DNA virus of the herpes virus family. In childhood, it is usually asymptomatic, while adolescents and adults present signs and symptoms of infectious mononucleosis in at least 50% of cases. Described in infectious mononucleosis, transaminase elevation is produced during the course of the disease, in approximately 80% of cases, while only jaundice occurs in 5-6.6%. In patients without jaundice, transaminase levels decreased to normal in about a month. Cholestasis alone rarely occurs in children and adolescents, with an average of 6%, but more occurs more commonly in adults, up to 55%. In most cases, it is a benign and self-limiting course; a very small group can have complications such as fulminant hepatitis, rare, but extremely serious, occurring only between 2-17% of cases. Treatment is symptomatic, and it is reported in case reports the sometime benefit with the use of acyclovir or ganciclovir. We present the case of a 16-year-old girl who started 4 weeks prior to admission, characterized by pruritus, jaundice, and fatigue. She referred to a recent trip (4 weeks) to Acapulco, Guerrero. Physical examination showed sclera jaundice and teguments, plus painless hepatomegaly. Laboratories at admission with cholestatic pattern were characterized by elevation of total bilirubin 18 mg / dL with a direct bilirubin of 14mg/dL, plus mild elevation of alkaline phosphatase (179 mg/dL); Albumin, transaminases, and coagulation were normal, so we started a study protocol performing an ultrasound of the abdomen, showing starry sky pattern in the liver without dilatation of intrahepatic or extrahepatic bile ducts; we performed a TORCH panel, subsequently resulting (+) for Epstein Barr IgM >160 (positive). The rest of the viral panel and immunologic (ANA, Antimitochondrial) were negative. We decided to start treatment with Acyclovir for a week without clinical or biochemical response. Instead, we had a significant increase in the cholestatic pattern, so we decided to change treatment to ganciclovir, having a significal improvement after 7 days both clinically and biochemically. This case is particularly relevant to us because the reported in the literature (case reports) is rarely cholestasis, the pattern of presentation by EPV. We recomend that patients admitted with cholestasis pattern without evidence of dilatation of intrahepatic or extrahepatic bile ducts start to rule out a viral panel and immunological tests. In this experience, we can emphasize that our patient had no response to the use of acyclovir, so we recommend starting treatment for EPV cholestasis with ganciclovir." @default.
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• W2977328009 date "2014-10-01" @default.
• W2977328009 modified "2023-10-14" @default.
• W2977328009 title "Cholestasis Due to Epstein Barr Virus: Case Report" @default.
• W2977328009 doi "https://doi.org/10.14309/00000434-201410002-01279" @default.
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