SEVERE HEPATITIS ASSOCIATED WITH EPSTEIN-BARR VIRUS IN CHILDHOOD

Clinical hepatitis caused by Epstein-Barr virus (EBV) has been recognized in the past and is usually benign. We described two children, 2 and 6 years of age with severe EBV hepatitis and hemolysis. One child died of hepatic failure. A liver biopsy obtained during the recovery stage in the other child showed focal necrosis of hepatocytes with mononclear cell infiltration. Fever and atypical lymphocytes were not found in either patient. An anti-VCA-lgM identified by indirect immunofluorescence was strongly positive in both patients. Herpes simplex antibody and HBV markers were negative. EBV infection as a cause of severe hepatitis may be missed in children lacking an infectious monocytosis-like syndrome unless this diagnosis is considered and serological examination is done.