Epstein Barr virus (EBV) infection causes asymptomatic liver-associated enzyme abnormalities in 80 to 90% of cases which are often unrecognized. Patients with acute EBV infections may also develop cholestatic hepatitis with associated jaundice and hepatitis with moderate elevations in the transaminase levels. Other gastrointestinal complications associated with EBV may include splenic rupture, liver failure due to acute and/or chronic EBV infection, and perhaps, autoimmune hepatitis and hepatocellular carcinoma. This article presents a case series of EBV infections with clinically significant hepatitis and reviews the literature on the gastrointestinal complications of EBV.
* Epstein Barr virus infections are commonly associated with asymptomatic, mildly elevated transaminase levels.
* Gastrointestinal manifestations of EBV infections may also include clinically significant hepatitis, jaundice, splenic rupture, and liver failure.
* Chronic EBV infections may play a role in the development of autoimmune hepatitis and hepatocellular carcinoma, but further data are needed.
* Patients with elevated liver function tests in the setting of symptoms such as fever, sore throat, and adenopathy should be evaluated for EBV.
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