Case Report
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Acute cholestatic hepatitis due to infectious mononucleosis: A case report

Year 2024, Volume: 6 Issue: 2, 97 - 101, 29.04.2024
https://doi.org/10.46310/tjim.1303184

Abstract

Cholestatic hepatitis is a rare complication of acute Epstein-Barr virus (EBV) infection. Here, we presented a case of acute cholestatic hepatitis secondary to acute infectious mononucleosis, who presented with complaints of abdominal pain, yellowing of the eyes and body, itching, widespread body pain, fever, nausea and vomiting. It was emphasized that EBV infection should also be considered in the differential diagnosis of cholestatic hepatitis etiology.

References

  • Johannsen EC, Kaye KM. Epstein-Barr virus (Infectious mononucleosis, Ebstein-Barr virus-associated malignant diseases, and other diseases). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed., Philadelphia: Churchill Livingstone Elsevier; 2010:1989-2010.
  • Johannsen EC, Schooley RT, Kaye KM. Epstein-Barr virus (Infectious mononucleosis). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:1801-20.
  • Luzuriaga K, Sullivan JL. Infectious mononucleosis. N Engl J Med. 2010 May 27;362(21):1993-2000. doi: 10.1056/NEJMcp1001116.
  • Arman D. İnfeksiyoz mononükleoz. In: Wilke Topçu A, Söyletir G, Doğanay M, eds. Infectious Diseases and Microbiology. 7th ed. Istanbul: Nobel Medicine Bookstores; 2008:696-701.
  • Lawee D. Mild infectious mononucleosis presenting with transient mixed liver disease: Case report with a literature review. Can Fam Physician. 2007 Aug;53(8):1314-6.
  • Tünay H, Özkan Kurtgöz P, Bozkurt E, Demir K, Aşık G, Acartürk G, Tuna Demirdal T. Cholestatic hepatitis due to Ebstein-Barr virus infection: A case report. Göztepe Medical Journal. 2012;27(3):131-4 (in Turkish).
  • Dikici N, Ural O. Cholestatic hepatitis due to Epstein-Barr virus: two cases. Turkish Journal of Infection. 2009;23(4):197-200 (in Turkish).
  • Macsween KF, Higgins CD, McAulay KA, Williams H, Harrison N, Swerdlow AJ, Crawford DH. Infectious mononucleosis in university students in the United kingdom: evaluation of the clinical features and consequences of the disease. Clin Infect Dis. 2010 Mar 1;50(5):699-706. doi: 10.1086/650456.
  • Kutok JL, Wang F. Spectrum of Epstein-Barr virus-associated diseases. Annu Rev Pathol. 2006;1:375-404. doi: 10.1146/annurev.pathol.1.110304.100209.
  • Hurt C, Tammaro D. Diagnostic evaluation of mononucleosis-like illnesses. Am J Med. 2007 Oct;120(10):911.e1-8. doi: 10.1016/j.amjmed.2006.12.011.
  • Finkel M, Parker GW, Fanselau HA. The hepatitis of infectious mononucleosis: Experience with 235 cases. Mil Med. 1964 Jun:129:533-8.
  • Drebber U, Kasper HU, Krupacz J, Haferkamp K, Kern MA, Steffen HM, Quasdorff M, Zur Hausen A, Odenthal M, Dienes HP. The role of Epstein-Barr virus in acute and chronic hepatitis. J Hepatol. 2006 May;44(5):879-85. doi: 10.1016/j.jhep.2006.02.006.
  • Vento S, Guella L, Mirandola F, Cainelli F, Di Perri G, Solbiati M, Ferraro T, Concia E. Epstein-Barr virus as a trigger for autoimmune hepatitis in susceptible individuals. Lancet. 1995 Sep 2;346(8975):608-9. doi: 10.1016/s0140-6736(95)91438-2.
  • imura H, Nagasaka T, Hoshino Y, Hayashi N, Tanaka N, Xu JL, Kuzushima K, Morishima T. Severe hepatitis caused by Epstein-Barr virus without infection of hepatocytes. Hum Pathol. 2001 Jul;32(7):757-62. doi: 10.1053/hupa.2001.25597.
  • Balfour HH Jr, Odumade OA, Schmeling DO, Mullan BD, Ed JA, Knight JA, Vezina HE, Thomas W, Hogquist KA. Behavioral, virologic, and immunologic factors associated with acquisition and severity of primary Epstein-Barr virus infection in university students. J Infect Dis. 2013 Jan 1;207(1):80-8. doi: 10.1093/infdis/jis646.
  • Ebell MH. Epstein-Barr virus infectious mononucleosis. Am Fam Physician. 2004 Oct 1;70(7):1279-87.
  • Wood TA, Frenkel EP. The atypical lymphocyte. Am J Med. 1967 Jun;42(6):923-36. doi: 10.1016/0002-9343(67)90073-3.
  • Mellinger JL, Rossaro L, Naugler WE, Nadig SN, Appelman H, Lee WM, Fontana RJ. Epstein-Barr virus (EBV) related acute liver failure: a case series from the US Acute Liver Failure Study Group. Dig Dis Sci. 2014 Jul;59(7):1630-7. doi: 10.1007/s10620-014-3029-2.
  • Ardıç E, Karaali R, Yağmur O, Atar RV, Kardan ME, Doğan M, Mete R, Erdem İ. A case of acute cholestatic hepatitis due to Epstein-Barr virus infection. Klimik Derg. 2020 Apr 29;33(1):100-2 (in Turkish). doi: 10.5152/kd.2020.20.
Year 2024, Volume: 6 Issue: 2, 97 - 101, 29.04.2024
https://doi.org/10.46310/tjim.1303184

Abstract

References

  • Johannsen EC, Kaye KM. Epstein-Barr virus (Infectious mononucleosis, Ebstein-Barr virus-associated malignant diseases, and other diseases). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed., Philadelphia: Churchill Livingstone Elsevier; 2010:1989-2010.
  • Johannsen EC, Schooley RT, Kaye KM. Epstein-Barr virus (Infectious mononucleosis). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:1801-20.
  • Luzuriaga K, Sullivan JL. Infectious mononucleosis. N Engl J Med. 2010 May 27;362(21):1993-2000. doi: 10.1056/NEJMcp1001116.
  • Arman D. İnfeksiyoz mononükleoz. In: Wilke Topçu A, Söyletir G, Doğanay M, eds. Infectious Diseases and Microbiology. 7th ed. Istanbul: Nobel Medicine Bookstores; 2008:696-701.
  • Lawee D. Mild infectious mononucleosis presenting with transient mixed liver disease: Case report with a literature review. Can Fam Physician. 2007 Aug;53(8):1314-6.
  • Tünay H, Özkan Kurtgöz P, Bozkurt E, Demir K, Aşık G, Acartürk G, Tuna Demirdal T. Cholestatic hepatitis due to Ebstein-Barr virus infection: A case report. Göztepe Medical Journal. 2012;27(3):131-4 (in Turkish).
  • Dikici N, Ural O. Cholestatic hepatitis due to Epstein-Barr virus: two cases. Turkish Journal of Infection. 2009;23(4):197-200 (in Turkish).
  • Macsween KF, Higgins CD, McAulay KA, Williams H, Harrison N, Swerdlow AJ, Crawford DH. Infectious mononucleosis in university students in the United kingdom: evaluation of the clinical features and consequences of the disease. Clin Infect Dis. 2010 Mar 1;50(5):699-706. doi: 10.1086/650456.
  • Kutok JL, Wang F. Spectrum of Epstein-Barr virus-associated diseases. Annu Rev Pathol. 2006;1:375-404. doi: 10.1146/annurev.pathol.1.110304.100209.
  • Hurt C, Tammaro D. Diagnostic evaluation of mononucleosis-like illnesses. Am J Med. 2007 Oct;120(10):911.e1-8. doi: 10.1016/j.amjmed.2006.12.011.
  • Finkel M, Parker GW, Fanselau HA. The hepatitis of infectious mononucleosis: Experience with 235 cases. Mil Med. 1964 Jun:129:533-8.
  • Drebber U, Kasper HU, Krupacz J, Haferkamp K, Kern MA, Steffen HM, Quasdorff M, Zur Hausen A, Odenthal M, Dienes HP. The role of Epstein-Barr virus in acute and chronic hepatitis. J Hepatol. 2006 May;44(5):879-85. doi: 10.1016/j.jhep.2006.02.006.
  • Vento S, Guella L, Mirandola F, Cainelli F, Di Perri G, Solbiati M, Ferraro T, Concia E. Epstein-Barr virus as a trigger for autoimmune hepatitis in susceptible individuals. Lancet. 1995 Sep 2;346(8975):608-9. doi: 10.1016/s0140-6736(95)91438-2.
  • imura H, Nagasaka T, Hoshino Y, Hayashi N, Tanaka N, Xu JL, Kuzushima K, Morishima T. Severe hepatitis caused by Epstein-Barr virus without infection of hepatocytes. Hum Pathol. 2001 Jul;32(7):757-62. doi: 10.1053/hupa.2001.25597.
  • Balfour HH Jr, Odumade OA, Schmeling DO, Mullan BD, Ed JA, Knight JA, Vezina HE, Thomas W, Hogquist KA. Behavioral, virologic, and immunologic factors associated with acquisition and severity of primary Epstein-Barr virus infection in university students. J Infect Dis. 2013 Jan 1;207(1):80-8. doi: 10.1093/infdis/jis646.
  • Ebell MH. Epstein-Barr virus infectious mononucleosis. Am Fam Physician. 2004 Oct 1;70(7):1279-87.
  • Wood TA, Frenkel EP. The atypical lymphocyte. Am J Med. 1967 Jun;42(6):923-36. doi: 10.1016/0002-9343(67)90073-3.
  • Mellinger JL, Rossaro L, Naugler WE, Nadig SN, Appelman H, Lee WM, Fontana RJ. Epstein-Barr virus (EBV) related acute liver failure: a case series from the US Acute Liver Failure Study Group. Dig Dis Sci. 2014 Jul;59(7):1630-7. doi: 10.1007/s10620-014-3029-2.
  • Ardıç E, Karaali R, Yağmur O, Atar RV, Kardan ME, Doğan M, Mete R, Erdem İ. A case of acute cholestatic hepatitis due to Epstein-Barr virus infection. Klimik Derg. 2020 Apr 29;33(1):100-2 (in Turkish). doi: 10.5152/kd.2020.20.
There are 19 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Case Reports
Authors

Oğuzhan Satılmış 0009-0007-8599-8752

Yasin Öztürk 0000-0003-2634-2677

Fethi Yönet 0000-0002-8534-3170

Hakan Ozer 0000-0001-9174-0351

Pınar Belviranlı Keskin This is me 0000-0003-3921-384X

İsmail Baloğlu 0000-0002-8751-5490

Mehmet Asıl 0000-0001-7332-686X

Halil Zeki Tonbul This is me 0000-0003-0761-3697

Publication Date April 29, 2024
Submission Date May 29, 2023
Acceptance Date February 4, 2024
Published in Issue Year 2024 Volume: 6 Issue: 2

Cite

EndNote Satılmış O, Öztürk Y, Yönet F, Ozer H, Belviranlı Keskin P, Baloğlu İ, Asıl M, Tonbul HZ (April 1, 2024) Acute cholestatic hepatitis due to infectious mononucleosis: A case report. Turkish Journal of Internal Medicine 6 2 97–101.

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