{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:17Z","timestamp":1756425797643,"version":"3.44.0"},"reference-count":6,"publisher":"SMC Media","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Epstein-Barr virus (EBV) is notorious for its varied presentation in adults. Reactivation of EBV can occur at any time and is often due to weakened cellular immunity.\u00a0 Case Description: Here we report the case of a young woman with no previous medical history who presented with cholestatic hepatitis, Coombs-negative haemolytic anaemia and splenomegaly. Due to the initial disjointed picture with no other localizing symptoms, she underwent extensive work-up for the same. Discussion: EBV has been associated with many malignancies, autoimmune diseases and chronic fatigue syndrome. EBV causes elevated liver enzymes; however, cholestatic hepatitis is exceedingly rare, with only a few cases reported. Haemolytic anaemia is a common complication of EBV infection and is often Coombs positive. Conclusion: EBV testing should be considered before more invasive and expensive work-up in a patient presenting with multi-systemic abnormalities.<\/jats:p>","DOI":"10.12890\/2021_002477","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T10:11:37Z","timestamp":1621937497000},"source":"Crossref","is-referenced-by-count":0,"title":["Coombs-Negative Haemolytic Anaemia, Direct Hyperbilirubinaemia and Splenomegaly: A Rare Amalgam"],"prefix":"10.12890","volume":"8","author":[{"given":"Radhika","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"UCONN Health, Farmington, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amjad","family":"Basheer","sequence":"additional","affiliation":[{"name":"UCONN Health, Farmington, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aziz","family":"Khan","sequence":"additional","affiliation":[{"name":"UCONN Health, Farmington, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2021,4,8]]},"reference":[{"key":"10.12890\/2021_002477_ref1","doi-asserted-by":"crossref","unstructured":"<li>Edoute Y, Baruch Y, Lachter J, Furman E, Bassan L, Assy N. Severe cholestatic jaundice induced by Epstein-Barr virus infection in the elderly. <em>J Gastroenterol Hepatol<\/em> 1998;<strong>13<\/strong>(8):821\u2013824. <\/li>","DOI":"10.1111\/j.1440-1746.1998.tb00739.x"},{"key":"10.12890\/2021_002477_ref2","doi-asserted-by":"crossref","unstructured":"<li>Teijido J, Tillotson K, Liu JM. A rare presentation of Epstein\u2013Barr virus infection. <em>J Emerg Med<\/em> 2020;<strong>58<\/strong>(2):e71\u201373. <\/li>","DOI":"10.1016\/j.jemermed.2019.11.043"},{"key":"10.12890\/2021_002477_ref3","doi-asserted-by":"crossref","unstructured":"<li>Feranchak AP, Tyson RW, Narkewicz MR, Karrer FM, Sokol RJ . Fulminant Epstein-Barr viral hepatitis: orthotopic liver transplantation and review of the literature. <em>Liver Transplant Surg<\/em> 1998;<strong>4<\/strong>(6):469\u2013476. <\/li>","DOI":"10.1002\/lt.500040612"},{"key":"10.12890\/2021_002477_ref4","doi-asserted-by":"crossref","unstructured":"<li>Shaqsi LA, Beamish J. P566 EBV related autoimmune haemolytic anaemia with a negative direct coomb\u2019s test \u2013 a case report. <em>Archives of Disease in Childhood<\/em> 2019;<strong>104<\/strong>:A380 <\/li>","DOI":"10.1136\/archdischild-2019-epa.900"},{"key":"10.12890\/2021_002477_ref5","doi-asserted-by":"crossref","unstructured":"<li>Kamesaki T, Oyamada T, Omine M, Ozawa K, Kajii E. Cut-off value of red-blood-cell-bound IgG for the diagnosis of Coombs-negative autoimmune hemolytic anemia. <em>Am J Hematol<\/em> 2009;<strong>84<\/strong>(2):98\u2013101. <\/li>","DOI":"10.1002\/ajh.21336"},{"key":"10.12890\/2021_002477_ref6","doi-asserted-by":"crossref","unstructured":"<li>Kerr JR. Epstein-Barr virus (EBV) reactivation and therapeutic inhibitors. <em>J Clin Pathol<\/em> 2019;<strong>72<\/strong>(10):651\u2013658.<\/li>","DOI":"10.1136\/jclinpath-2019-205822"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2477\/2634","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2477\/2635","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2477\/2635","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:27:05Z","timestamp":1756369625000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/2477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,8]]},"references-count":6,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.12890\/2021_002477","relation":{"has-manifestation":[{"id-type":"other","id":"1-70-2477-g2634","asserted-by":"subject"},{"id-type":"other","id":"1-70-2477-g2635","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-70","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"type":"electronic","value":"2284-2594"}],"subject":[],"published":{"date-parts":[[2021,4,8]]},"article-number":"19"}}