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Accomando S, Restivo GA, Scalzo S, Guardino M, Corsello G, Giuffrè M. Epstein-Barr virus-associated acute pancreatitis: a clinical report and review of literature. Ital J Pediatr 2022; 48:160. [PMID: 36064422 PMCID: PMC9446836 DOI: 10.1186/s13052-022-01352-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Acute pancreatitis is a disorder of reversible inflammation of the pancreas. Only a few cases are related to infections and the most common pathogens are the viruses responsible for mumps, parotitis, and influenza. Epstein-Barr virus (EBV)-associated acute pancreatitis is a rare condition and it may occur in children and adults. Case presentation A 3-year-old female was admitted to the “G. Di Cristina” Children's Hospital in Palermo for vomiting and abdominal pain. Laboratory investigations revealed elevated amylase and lipase, with normal liver function tests. Abdominal ultrasound demonstrated an enlarged pancreas, with hypoechogenic areas; no biliary lithiasis was observed. Infectious disease serology was positive for the presence of EBV VCA IgM and IgG. A diagnosis of EBV-associated acute pancreatitis was made. The patient was treated conservatively and recovered. Conclusions Acute pancreatitis is rarely associated with EBV infection; a review of the English literature revealed only 10 pediatric and 6 adult cases. Patients with pancreatitis should always be evaluated for EBV serology, even in the absence of the typical clinical and hematological features of infectious mononucleosis. For these patients, good prognosis is generally expected.
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Affiliation(s)
- Salvatore Accomando
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Piazza Delle Cliniche, 2, 90127, Palermo, Italy
| | - Giulia Angela Restivo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Piazza Delle Cliniche, 2, 90127, Palermo, Italy
| | - Simona Scalzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Piazza Delle Cliniche, 2, 90127, Palermo, Italy.
| | - Melania Guardino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Piazza Delle Cliniche, 2, 90127, Palermo, Italy
| | - Giovanni Corsello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Piazza Delle Cliniche, 2, 90127, Palermo, Italy
| | - Mario Giuffrè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Piazza Delle Cliniche, 2, 90127, Palermo, Italy
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Hammami MB, Aboushaar R, Musmar A, Hammami S. Epstein-Barr virus-associated acute pancreatitis. BMJ Case Rep 2019; 12:12/11/e231744. [PMID: 31732544 DOI: 10.1136/bcr-2019-231744] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Epstein-Barr virus (EBV) infection is mostly subclinical and resolves spontaneously without complications. Gastroenterology involvement usually manifests as asymptomatic liver enzymes elevation. We report a new case of acute pancreatitis complicating EBV infection and review the literature. EBV-associated acute pancreatitis is rare, usually develops in the setting of clinically clear EBV infection, occurs mostly in children and young adults, has mild-to-moderate severity, and has excellent prognosis with conservative management. It should be suspected when patients with an EBV infection picture develop unexplained abdominal pain.
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Affiliation(s)
| | - Reem Aboushaar
- Internal Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Ahmad Musmar
- Internal Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Safa Hammami
- Internal Medicine, Dignity Health, San Francisco, California, USA
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Kottanattu L, Lava SAG, Helbling R, Simonetti GD, Bianchetti MG, Milani GP. Pancreatitis and cholecystitis in primary acute symptomatic Epstein-Barr virus infection - Systematic review of the literature. J Clin Virol 2016; 82:51-55. [PMID: 27434148 DOI: 10.1016/j.jcv.2016.06.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/24/2016] [Accepted: 06/28/2016] [Indexed: 02/07/2023]
Abstract
Acute pancreatitis and acalculous cholecystitis have been occasionally reported in primary acute symptomatic Epstein-Barr virus infection. We completed a review of the literature and retained 48 scientific reports published between 1966 and 2016 for the final analysis. Acute pancreatitis was recognized in 14 and acalculous cholecystitis in 37 patients with primary acute symptomatic Epstein-Barr virus infection. In all patients, the features of acute pancreatitis or acalculous cholecystitis concurrently developed with those of primary acute symptomatic Epstein-Barr virus infection. Acute pancreatitis and acalculous cholecystitis resolved following a hospital stay of 25days or less. Acalculous cholecystitis was associated with Gilbert-Meulengracht syndrome in two cases. In conclusion, this thorough analysis indicates that acute pancreatitis and acalculous cholecystitis are unusual but plausible complications of primary acute symptomatic Epstein-Barr virus infection. Pancreatitis and cholecystitis deserve consideration in cases with severe abdominal pain. These complications are usually rather mild and resolve spontaneously without sequelae.
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Affiliation(s)
- Lisa Kottanattu
- Pediatric Department of Southern Switzerland, Bellinzona, Switzerland.
| | - Sebastiano A G Lava
- Pediatric Department of Southern Switzerland, Bellinzona, Switzerland; University Children's Hospital, Inselspital, and University of Bern, Bern, Switzerland.
| | - Rossana Helbling
- Pediatric Department of Southern Switzerland, Bellinzona, Switzerland.
| | - Giacomo D Simonetti
- Pediatric Department of Southern Switzerland, Bellinzona, Switzerland; University Children's Hospital, Inselspital, and University of Bern, Bern, Switzerland.
| | | | - Gregorio P Milani
- Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Pediatric Emergency Department, Milan, Italy.
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