title: Pancreatitis and cholecystitis in primary acute symptomatic Epstein-Barr virus infection - Systematic review of the literature.
abstract: Acute pancreatitis and acalculous cholecystitis have been occasionally reported in primary acute symptomatic Epstein-Barr virus infection. We completed a review of the literature and retained 48 scientific reports published between 1966 and 2016 for the final analysis. Acute pancreatitis was recognized in 14 and acalculous cholecystitis in 37 patients with primary acute symptomatic Epstein-Barr virus infection. In all patients, the features of acute pancreatitis or acalculous cholecystitis concurrently developed with those of primary acute symptomatic Epstein-Barr virus infection. Acute pancreatitis and acalculous cholecystitis resolved following a hospital stay of 25days or less. Acalculous cholecystitis was associated with Gilbert-Meulengracht syndrome in two cases. In conclusion, this thorough analysis indicates that acute pancreatitis and acalculous cholecystitis are unusual but plausible complications of primary acute symptomatic Epstein-Barr virus infection. Pancreatitis and cholecystitis deserve consideration in cases with severe abdominal pain. These complications are usually rather mild and resolve spontaneously without sequelae.
authors.affiliation: Pediatric Department of Southern Switzerland, Bellinzona, Switzerland. Electronic address: lisa.kottanattu@eoc.ch.
authors.forename: Lisa
authors.initials: L
authors.lastname: Kottanattu
authors.affiliation: Pediatric Department of Southern Switzerland, Bellinzona, Switzerland; University Children's Hospital, Inselspital, and University of Bern, Bern, Switzerland. Electronic address: sebastiano.lava@bluewin.ch.
authors.forename: Sebastiano A G
authors.initials: SAG
authors.lastname: Lava
authors.affiliation: Pediatric Department of Southern Switzerland, Bellinzona, Switzerland. Electronic address: rhelbling@me.com.
authors.forename: Rossana
authors.initials: R
authors.lastname: Helbling
authors.affiliation: Pediatric Department of Southern Switzerland, Bellinzona, Switzerland; University Children's Hospital, Inselspital, and University of Bern, Bern, Switzerland. Electronic address: giacomo.simonetti@eoc.ch.
authors.forename: Giacomo D
authors.initials: GD
authors.lastname: Simonetti
authors.affiliation: Pediatric Department of Southern Switzerland, Bellinzona, Switzerland. Electronic address: mario.bianchetti@pediatrician.ch.
authors.forename: Mario G
authors.initials: MG
authors.lastname: Bianchetti
authors.affiliation: Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Pediatric Emergency Department, Milan, Italy. Electronic address: milani.gregoriop@gmail.com.
authors.forename: Gregorio P
authors.initials: GP
authors.lastname: Milani
mesh_terms: D042101:Acalculous Cholecystitis / Q000209:etiology* / Q000473:pathology*; D020031:Epstein-Barr Virus Infections / Q000473:pathology*; D004854:Herpesvirus 4, Human; D006801:Humans; D010195:Pancreatitis / Q000209:etiology* / Q000473:pathology*; D016896:Treatment Outcome
keywords: Acalculous cholecystitis; Epstein-Barr virus; Infectious mononucleosis; Pancreatitis