Epstein-Barr virus (EBV) infection in children and adolescents clinically presents as infectious mononucleosis and usually leads to self limited elevation of liver enzymes but cholestatic hepatitis with jaundice is rare. We present a 16-year-old female with fever, fatigue, vomiting, choluria and jaundice. Physical examination showed a painful abdomen and the remaining examination was unremarkable. Laboratory tests results revealed leucocytosis and activated lymphocytes, normal haemoglobin level, the elevation of transaminases more than 7 times the upper limit, cholestasis and hypoalbuminemia. The abdominal ultrasound showed mild hepatosplenomegaly. Viral serologies revealed positive EBV viral capsid antibody IgM and negative IgG and were negative for other viral agents. Later she developed haemolytic anaemia. She received support treatment and fully recovered. We emphasize that EBV infection should be considered in patients with cholestatic hepatitis with jaundice.
Key words: Epstein-Barr virus, cholestasis, hepatitis, hyperbilirubinemia, jaundice