You have 1 free disease view remaining today. Register for more view, it is 100% free →
Epstein-Barr virus hepatitis
ICD-10 Codes
Related ICD-10:
Description
Epstein-Barr virus (EBV) hepatitis is a rare but serious complication of infectious mononucleosis, caused by the EBV virus.
Symptoms and Characteristics
- The symptoms of EBV hepatitis are similar to those of other forms of viral hepatitis, including:
- Fatigue [3]
- Fever [3]
- Night sweats [3]
- Muscle weakness [3]
- Rash with flat pink or purple spots [3]
- Swollen lymph nodes [7]
- The liver involvement in acute EBV infection is typically mild and self-limited, with predominantly cholestatic features [4].
- Histopathologic features of EBV hepatitis include a diffuse lymphocytic sinusoidal infiltrate in a "string of beads" pattern, expansion of portal tracts, and focal necrosis [2].
Diagnosis
- EBV hepatitis is typically diagnosed clinically, but a liver biopsy may be indicated if the clinical presentation is atypical or laboratory findings are ambiguous or unusual.
- The diagnosis can also be supported by serological tests for EBV-specific antibodies.
Prevention and Treatment
- There is no specific treatment for EBV hepatitis, as it is usually self-limiting. However, supportive care such as rest, hydration, and pain management may be necessary to alleviate symptoms.
- Prevention of EBV infection through good hygiene practices, such as frequent handwashing and avoiding close contact with infected individuals, can help reduce the risk of developing EBV hepatitis.
References:
[1] Theodory B. (2023) Additional symptoms of EBV infection include malaise, splenomegaly, and maculopapular skin rash [6].
[2] Schechter S. (2018) Characteristic microscopic findings in EBV hepatitis include a diffuse lymphocytic sinusoidal infiltrate in a "string of beads" pattern, expansion of portal tracts, and focal necrosis [1].
[3] Nov 4, 2022 - What are the symptoms of EBV hepatitis? [3]
[4] Kofteridis DP. (2011) Liver involvement in acute EBV infection represents mild and self-limited hepatitis with predominantly cholestatic features [4].
[5] Dec 4, 2023 - Hepatitis can be a complication of mononucleosis, a contagious illness caused by the Epstein-Barr virus [5].
Additional Characteristics
- fatigue
- fever
- muscle weakness
- night sweats
- Epstein-Barr virus (EBV) hepatitis
- rash with flat pink or purple spots
- swollen lymph nodes
- diffuse lymphocytic sinusoidal infiltrate in a 'string of beads' pattern
- expansion of portal tracts
- focal necrosis
Signs and Symptoms
Common Signs and Symptoms of Epstein-Barr Virus Hepatitis
Epstein-Barr virus (EBV) hepatitis can manifest in various ways, and its symptoms may overlap with those of other conditions. Here are some common signs and symptoms associated with EBV hepatitis:
- Hepatomegaly: Enlargement of the liver is a common characteristic of EBV hepatitis, affecting more than 20% of patients [5].
- Jaundice: Jaundice, or yellowing of the skin and eyes, can occur in about 5% of patients with EBV hepatitis [4, 5].
- Splenomegaly: Enlargement of the spleen (splenomegaly) is another common symptom, affecting around 50% of patients [4, 5].
- Fever: Fever is a non-specific symptom that can occur in various conditions, including EBV hepatitis.
- Fatigue: Prolonged malaise and fatigue are common presentations of EBV infection, including hepatitis [7].
Other Possible Symptoms
In addition to the above symptoms, some patients may experience:
- Sore throat: Sore throat is a common symptom of infectious mononucleosis, which can be caused by EBV.
- Swollen lymph nodes: Swollen lymph nodes in the neck and armpits can occur due to EBV infection.
- Headaches and body aches: Some patients may experience headaches and body aches as part of their symptoms.
Important Note
It's essential to note that these symptoms can be similar to those of other conditions, such as hepatitis A or B. Therefore, a proper diagnosis by a healthcare professional is crucial for accurate identification and treatment of EBV hepatitis.
References:
[4] - Context result 5 [5] - Context result 5 [7] - Context result 7
Additional Symptoms
- Sore throat
- Swollen lymph nodes
- Headaches and body aches
- hepatomegaly
- splenomegaly
- jaundice
- fever
- fatigue
Diagnostic Tests
Diagnosing Epstein-Barr Virus Hepatitis
Epstein-Barr virus (EBV) hepatitis can be challenging to diagnose, but various tests can help confirm the presence of the infection. Here are some diagnostic tests used to detect EBV hepatitis:
- Blood Tests: Blood tests for EBV detect antibodies to the virus in the blood. These tests can establish a diagnosis of EBV infection and are often used to monitor the progression of the disease [2][3].
- Epstein-Barr Virus Antibody Test: This test takes a sample of your blood to detect antibodies that cause EBV. Your provider may need to repeat the test between 10 days to two weeks after the first test because antibodies might not show up early in your diagnosis [3].
- EBV PCR (Polymerase Chain Reaction): EBV PCR is a noninvasive laboratory test that helps identify primary EBV infection, especially in cases where the clinical presentation is atypical. This test detects the genetic material of the virus in the blood [14].
Other Diagnostic Tests
While not specifically used to diagnose EBV hepatitis, other tests can help confirm the presence of EBV infection:
- Molecular Tests: Molecular tests can detect and measure EBV DNA, which can be helpful in diagnosing and monitoring EBV-related diseases such as Burkitt's lymphoma [9].
- Imaging Services: Imaging services like MRI scans, CT scans, X-rays, ultrasounds & screening mammograms may be used to rule out other conditions that may present with similar symptoms [13].
Important Considerations
It is essential to note that the diagnosis of EBV hepatitis can be complex and may require a combination of these tests. A healthcare provider will determine the best course of action for diagnosing and treating EBV hepatitis.
References:
[2] Blood tests for Epstein-Barr virus detect antibodies to EBV in the blood and help establish a diagnosis of EBV infection. [3] To confirm your diagnosis, your provider will perform a blood test called Epstein-Barr virus antibody test. [9] Molecular tests can detect and measure EBV DNA. [14] EBV PCR is a noninvasive laboratory test that helps identify primary EBV infection.
Additional Diagnostic Tests
- Blood Tests
- Epstein-Barr Virus Antibody Test
- EBV PCR (Polymerase Chain Reaction)
- Molecular Tests
- Imaging Services
Treatment
Treatment for EBV Hepatitis
The treatment for Epstein-Barr virus (EBV) hepatitis is generally supportive, as most cases will resolve on their own after the infection runs its course [9]. However, some antiviral drugs have been studied to reduce EBV shedding and alleviate symptoms.
- Acyclovir and ganciclovir may reduce EBV shedding, but are ineffective clinically [6].
- Valganciclovir has been used in some cases to help resolve fever and improve symptoms [8].
It's essential to note that there is no specific treatment for EBV hepatitis. Treatment focuses on relieving symptoms such as dehydration and pain.
Medications Used
Some medications may be prescribed to alleviate symptoms, including:
- Over-the-counter (OTC) fever and pain medications
- Antiviral drugs like acyclovir and ganciclovir (although their effectiveness is limited)
- Valganciclovir in some cases
Supportive Care
In addition to medication, supportive care plays a crucial role in managing EBV hepatitis. This includes:
- Resting and staying hydrated
- Managing pain and discomfort with OTC medications
- Avoiding strenuous activities until symptoms have subsided
Recommended Medications
💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.
Differential Diagnosis
Differential Diagnosis of Epstein-Barr Virus (EBV) Hepatitis
EBV hepatitis is a rare condition that can be challenging to diagnose, as it presents similarly to other liver conditions. To differentiate EBV hepatitis from other causes of liver disease, consider the following:
- Autoimmune hepatitis: This condition involves an immune response against the liver, leading to inflammation and damage. EBV hepatitis can be distinguished by its self-limiting nature and lack of autoimmune markers [1].
- Lymphoproliferative disorders: These conditions involve abnormal growth of lymphocytes in the body, which can affect the liver. EBV hepatitis is characterized by a mild, self-limited course, whereas lymphoproliferative disorders often have a more severe prognosis [2].
- Drug-induced liver injury: This condition occurs when medications or substances cause liver damage. EBV hepatitis can be distinguished by its association with viral infection and lack of exposure to hepatotoxic agents [3].
- Infectious mononucleosis: While EBV is the primary cause of infectious mononucleosis, other viruses such as CMV, HIV, Toxoplasma, human herpesvirus type 6 (HHV-6), hepatitis B, and HHV-7 can present similarly [4].
- Transient cholestasis and increased alkaline phosphatase: EBV infection should be considered in the differential diagnosis of patients with these symptoms, as it can cause mild liver dysfunction [5].
To accurately diagnose EBV hepatitis, consider a combination of clinical presentation, laboratory tests (such as liver function tests and viral serology), and imaging studies. Correlation with other conditions is also essential to rule out alternative diagnoses.
References:
[1] by S Schechter · 2018 · Cited by 47 — Characteristic microscopic findings in EBV hepatitis include a diffuse lymphocytic sinusoidal infiltrate in a "string of beads" pattern, expansion of portal ...
[2] by LJ Vine · 2012 · Cited by 110 — EBV hepatitis is an uncommon diagnosis and causes a self-limiting hepatitis. The diagnosis is suggested by the presence of a lymphocytosis and/or splenomegaly.
[3] by DP Kofteridis · 2011 · Cited by 173 — Thus, liver involvement in EBV infection is a mild, self-limited, predominantly cholestatic liver disease, and should be considered in the differential ...
[4] by J Shah · 2020 · Cited by 10 — To differentiate EBV hepatitis from other conditions, such as autoimmune hepatitis, lymphoproliferative disorders, and drug-induced liver injury, correlation ...
[5] by B Theodory · 2023 · Cited by 5 — Acute EBV-hepatitis is an uncommon diagnosis and accounts for less than 1% of acute and chronic hepatitis causes. Compared with infectious mononucleosis, EBV- ...
Additional Differential Diagnoses
- Drug-induced liver injury
- Lymphoproliferative disorders
- Transient cholestasis and increased alkaline phosphatase
- autoimmune hepatitis
- infectious mononucleosis
Additional Information
- core#notation
- DOID:0050204
- rdf-schema#subClassOf
- t327887
- rdf-schema#domain
- https://w3id.org/def/predibionto#has_symptom_258
- owl#annotatedSource
- t328120
- oboInOwl#hasOBONamespace
- disease_ontology
- oboInOwl#id
- DOID:0050204
- IAO_0000115
- A viral hepatitis that results_in inflammation, located_in liver, has_material_basis_in Human herpesvirus 4 and has_symptom headache, has_symptom fatigue, has_symptom fever, has_symptom abdominal pain, has_symptom nausea, and has_symptom jaundice.
- rdf-schema#label
- Epstein-Barr virus hepatitis
- oboInOwl#inSubset
- http://purl.obolibrary.org/obo/doid#DO_infectious_disease_slim
- RO_0002452
- http://purl.obolibrary.org/obo/SYMP_0019177
- IDO_0000664
- http://purl.obolibrary.org/obo/NCBITaxon_10376
- relatedICD
- http://example.org/icd10/D89.9
- 22-rdf-syntax-ns#type
- http://www.w3.org/2002/07/owl#Class
Medical Disclaimer: The information provided on this website is for general informational and educational purposes only.
It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with questions about your medical condition.