Severe cholestatic jaundice induced by Epstein-Barr virus infection in the elderly.
Infectious mononucleosis due to Epstein-Barr virus (EBV) is almost always a self-limited disease, most commonly seen in young adults. Hepatitis is a well-recognized complication of EBV infection that usually resolves spontaneously. Jaundice occasionally results from the unusual complication of autoimmune haemolytic anaemia rather than hepatitis. We report a 60-year-old man with severe cholestatic jaundice whose history, liver histology and laboratory findings suggested EBV infection. He also developed significant jaundice related to his hepatitis, but not to autoimmune haemolysis, a situation that led to diagnostic delay. Costly diagnostic laboratory tests and invasive procedures were performed to rule out a malignant extrahepatic biliary obstruction. Physicians need to be aware of this complication and EBV infection should be included in the differential diagnosis of cholestatic jaundice in the elderly.
Edoute
Y
Y
Department of Internal Medicine C, Rambam Medical Centre and The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.
Baruch
Y
Y
Lachter
J
J
Furman
E
E
Bassan
L
L
Assy
N
N
D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis; D002779:Cholestasis / Q000209:etiology*; D003937:Diagnosis, Differential; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000175:diagnosis*; D004854:Herpesvirus 4, Human; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications* / Q000175:diagnosis*; D008297:Male