Clinical characteristics of primary Epstein Barr virus hepatitis with elevation of alkaline phosphatase and γ-glutamyltransferase in children

• Published in: Yonsei medical journal Vol. 55; no. 1; pp. 107 - 112
• Main Authors: Yang, Soo In, Geong, Jwa Hye, Kim, Jae Young
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.01.2014; 연세대학교의과대학
• Subjects: Alkaline Phosphatase - genetics; Alkaline Phosphatase - metabolism; Child; Child, Preschool; Female; gamma-Glutamyltransferase - genetics; gamma-Glutamyltransferase - metabolism; Hepatitis - enzymology; Hepatitis - pathology; Hepatitis - virology; Herpesvirus 4, Human - pathogenicity; Humans; Infant; Male; Original; 의학일반; γ-glutamy-ltransferase; alkaline phosphatase; children; Primary Epstein-Barr virus hepatitis
• ISSN: 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2014.55.1.107

The aim of the present study was to evaluate the clinical characteristics of the primary Epstein-Barr virus (EBV) hepatitis with elevation of both serum alkaline phosphatase (ALP) and γ-glutamyltransferase (γ-GT) levels in children. A retrospective study was performed by reviewing of the medical records of 36 patients who were diagnosed with primary EBV hepatitis. The patients were divided into 2 groups: patients with elevated serum ALP and γ-GT levels (group 1) and patients without (group 2). The classic features of infectious mononucleosis (fever, pharyngitis and/or tonsillitis, and cervical lymphadenitis) were seen in 20 (57.1%) of group 1 patients and 18 (50.0%) of group 2 patients. Hepatitis with elevated serum ALP and γ-GT levels were present in 14 (38.9%) of the all patients. Of these patients, Jaundice occurred in only 2 (5.6%). The mean levels of aspartate aminotransferase and alanine aminotransferase (ALT) as well as the number of patients with ALT greater than 400 IU/L were significantly different between the groups (177 IU/L vs. 94 IU/L, 418 IU/L vs. 115 IU/L, and 50.0% vs. 13.6%; p=0.001, p=0.001, p=0.026, respectively). The mean duration of elevated serum ALT levels was 17.5 days in group 1 and 9.0 days in group 2 (p=0.013). All patients recovered fully without any chronic or serious complications. Primary EBV hepatitis with predominant biochemical abnormalities of the elevation of ALP and γ-GT is frequent and mostly anicteric. This may represent a benign disease, but a delay in recovery of liver function as well.