{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T07:10:42Z","timestamp":1773645042889,"version":"3.50.1"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cholestatic jaundice is uncommon in adolescents. Epstein\u2013Barr virus (EBV)\u2013related inflammatory lymphadenopathy can mimic malignant biliary obstruction and cause a transient rise in carbohydrate antigen 19-9 (CA 19-9), complicating diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A previously healthy 15-year-old girl presented with 6 days of jaundice and dark urine without fever. Physical examination showed moderate generalized jaundice with mild scleral icterus; multiple mobile, non-tender lymph nodes in the bilateral cervical regions and right post-auricular area (largest \u223c2\u2009\u00d7\u20092\u2005cm); palpable liver and spleen; and mild right upper-quadrant tenderness with equivocal Murphy's sign. Initial tests showed a cholestatic pattern (total\/direct bilirubin 102.4\/67.7\u2005\u03bcmol\/L at the referring hospital; and 133.2\/126.3\u2005\u03bcmol\/L on admission) with elevated ALP\/GGT and total bile acids. CT suggested a porta hepatis-to-pancreatic-head soft-tissue density with mild intrahepatic ductal prominence; CA 19-9 was 117.7\u2005U\/mL [ref &amp;lt;37\u2005U\/mL]. EBV POCT was positive; EBV DNA was detected at low level. MRI\/MRCP (2025-09-29) showed no obvious biliary obstruction. After MRCP excluded fixed biliary obstruction, the patient improved with conservative management (diagnostic evaluation, close monitoring, and symptom-directed care) without invasive intervention; CA 19-9 declined. No causal inference regarding any medication effect should be drawn, and we do not recommend self-medication or routine off-label\/unlicensed use of cholestasis-directed agents for EBV infection. In immunocompetent hosts, EBV-related lymphadenopathy is usually self-limited, and this case does not represent EBV-associated lymphoproliferative disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EBV-related cholestatic hepatitis in adolescents can present with transient CA 19-9 elevation and reactive porta hepatis\/pancreatic head lymphadenopathy, mimicking malignant obstruction. Serial laboratory and imaging assessments\u2014particularly MRCP\u2014together with conservative management may obviate unnecessary invasive procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1760882","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T06:38:34Z","timestamp":1773643114000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adolescent Epstein\u2013Barr virus\u2013associated cholestatic jaundice with porta hepatis\/pancreatic head lymphadenopathy and transient CA 19-9 elevation: a case report"],"prefix":"10.3389","volume":"14","author":[{"given":"Ying","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Yibin Hospital Affiliated to Children's Hospital of Chongqing Medical University","place":["Yibin, 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