title: Ultrasonographic Gallbladder Abnormality of Primary Epstein-Barr Virus Infection in Children and Its Influence on Clinical Outcome.
abstract: The incidence of pediatric acute inflammatory gallbladder (GB) disease without gallstone such as acute acalculous cholecystitis has increased with the development of improved diagnostic modalities. Although Epstein-Barr virus (EBV) infection is common in general population, only few cases of GB diseases caused by EBV infection have been reported. This study analyzed ultrasonographic characteristics of primary EBV infection in children and evaluated the influence of EBV-associated GB disease on clinical course and outcome of EBV infection.Between March 2004 and January 2013, 94 of 287 pediatric patients with EBV infection underwent abdominal ultrasonography (USG); clinical features, laboratory data, and USG findings were collected and analyzed retrospectively.Of 94 children, ultrasonographic thick GB wall was observed in 24 (25.3%). Platelet counts were lower in the thickened GB wall group than in the normal GB wall thickness group (P = 0.004). Direct bilirubin, alanine aminotransferase, and γ-glutamyl transferase levels were higher in the thickened GB wall group (P = 0.000, P = 0.041, and P = 0.001, respectively). The duration of hospitalization was longer in patients with thickened GB wall (P = 0.043).Radiologic findings of acute acalculous inflammatory GB disease such as thickened GB wall caused by primary EBV infection are more common than previously reported. Consideration of EBV infection in the differential diagnosis of children suspected with acute acalculous GB diseases may avoid unnecessary surgical intervention.
authors.affiliation: From Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea (DYY, HRY); Department of Pediatrics, Chung-Ang University Hospital, Seoul, Republic of Korea (DYY); Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea (JYK); and Seoul National University College of Medicine, Seoul, Republic of Korea (HRY).
authors.forename: Dae Yong
authors.initials: DY
authors.lastname: Yi
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Yang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002764:Cholecystitis / Q000000981:diagnostic imaging / Q000209:etiology*; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D005704:Gallbladder / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008297:Male; D010976:Platelet Count; D012189:Retrospective Studies; D014463:Ultrasonography