title: Clinical characteristics of primary Epstein Barr virus hepatitis with elevation of alkaline phosphatase and γ-glutamyltransferase in children.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Pediatrics, School of Medicine, Chungnam National University, 282 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea. pedkim@cnuh.co.kr.
authors: Soo In
authors: SI
authors: Yang
authors: Jwa Hye
authors: JH
authors: Geong
authors: Jae Young
authors: JY
authors: Kim
mesh_terms: D000469:Alkaline Phosphatase / Q000235:genetics / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006505:Hepatitis / Q000201:enzymology* / Q000473:pathology* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000472:pathogenicity*; D006801:Humans; D007223:Infant; D008297:Male; D005723:gamma-Glutamyltransferase / Q000235:genetics / Q000378:metabolism*
chemical_list: D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase
keywords: Primary Epstein-Barr virus hepatitis; alkaline phosphatase; children; γ-glutamy-ltransferase