{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T06:54:18Z","timestamp":1763535258582,"version":"3.40.4"},"reference-count":17,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Epstein-Barr virus infection is common in children, usually presenting as infectious mononucleosis, including fever, tonsillitis and lymphadenopathy associated with self-resolving increase in transaminases. Cholestasis is rare in children with only a few cases reported but it was described in up to 55% of the adult population affected. We present a case of a 6-year-old boy with fever, vomiting and choluria. The physical examination showed hepatomegaly and jaundice and was otherwise unremarkable. The laboratory studies revealed increased transaminases (aspartate aminotransferase 97\u2005U\/L, alanine aminotransferase 166 U\/L), hyperbilirubinaemia (total bilirubin 3.2\u2005mg\/dL, direct bilirubin 2.89\u2005mg\/dL) and increased \u03b3-glutamyl transpeptidase (114\u2005mg\/dL). Urine urobilinogen was increased. The abdominal ultrasound showed hepatomegaly. Epstein-Barr viral capsid antibody IgM was positive and IgG was negative. Serological studies for other viruses were negative. We underline the need to consider Epstein-Barr virus in the cholestatic hepatitis differential diagnosis, in order to avoid unnecessary investigations.<\/jats:p>","DOI":"10.1136\/bcr-2013-202213","type":"journal-article","created":{"date-parts":[[2013,12,16]],"date-time":"2013-12-16T16:58:30Z","timestamp":1387213110000},"page":"bcr2013202213","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Epstein-Barr virus-associated cholestatic hepatitis"],"prefix":"10.1136","volume":"2013","author":[{"given":"In\u00eas","family":"Salva","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00eas Vaz","family":"Silva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florbela","family":"Cunha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,12,16]]},"reference":[{"doi-asserted-by":"publisher","key":"2025042709493758000_2013.dec16_1.bcr2013202213.1","DOI":"10.1097\/01.smj.0000216469.04854.2a"},{"key":"2025042709493758000_2013.dec16_1.bcr2013202213.2","first-page":"251","article-title":"Epstein-Barr virus, cytomegalovirus, and infectious mononucleosis","volume":"21","author":"Bravender","year":"2010","journal-title":"Adolesc Med State Art Rev"},{"key":"2025042709493758000_2013.dec16_1.bcr2013202213.3","first-page":"483","article-title":"Epstein-Barr virus infection and acute cholestatic hepatitis","volume":"23","author":"Barreales","year":"2006","journal-title":"An Med Interna"},{"key":"2025042709493758000_2013.dec16_1.bcr2013202213.4","first-page":"33","article-title":"A rare presentation on EBV hepatitis","volume":"4","author":"Demirdal","year":"2007","journal-title":"Eur J Gen Med"},{"unstructured":"Center for Disease Control and Prevention. 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