ABSTRACT
The most commonly known clinical manifestation of primary Epstein-Barr virus infection is infectious mononucleosis. In this review we cover the diagnostics and basic patho-physiology of Epstein-Barr virus infection and present the many clinical manifestations of the virus, including less well-known diseases such as hepatitis, auto-immune haemolytic anaemia, and neurological and immunological diseases. Our aim is to strengthen the clinicians' awareness and understanding of these conditions in order to improve diagnostics and avoid delay of treatment.
Subject(s)
Epstein-Barr Virus Infections , Adolescent , Anemia, Hemolytic, Autoimmune/virology , Child , Child, Preschool , Encephalitis, Viral/virology , Epstein-Barr Virus Infections/complications , Epstein-Barr Virus Infections/diagnosis , Epstein-Barr Virus Infections/pathology , Epstein-Barr Virus Infections/physiopathology , Hepatitis, Viral, Human/virology , Herpesvirus 4, Human/isolation & purification , Humans , Infant , Infectious Mononucleosis/virology , Lymphohistiocytosis, Hemophagocytic/virologyABSTRACT
Migraine is common and well-known in the adult population, but also frequent among children. In this review, the latest evidence on how to treat migraine in children is presented. The headache diary in which the episodes of headache are recorded, is an important tool in order to optimize the medical treatment and to avoid identified trigger factors. While the acute treatment of migraine is well-established, preventive medical treatment is not strongly evidence-based and should only be used in selected cases of severe or refractive migraine.
Subject(s)
Migraine Disorders , Adolescent , Analgesics/administration & dosage , Analgesics/therapeutic use , Antiemetics/administration & dosage , Antiemetics/therapeutic use , Child , Humans , Medical Records , Migraine Disorders/classification , Migraine Disorders/diagnosis , Migraine Disorders/drug therapy , Migraine Disorders/prevention & controlABSTRACT
Epstein-Barr virus (EBV) is globally prevalent and in adolescents mostly observed as infectious mononucleosis. Abnormal liver blood tests are common, whereas more serious hepatitis is less prevalent. Autoimmune haemolytic anaemia may also occur in the course of this infection. We report a case of a 15-year-old girl with cholestatic hepatitis and autoimmune haemolytic anaemia associated with EBV infection. The Donath-Landsteiner test was positive suggesting paroxysmal cold haemoglobinuria. She was treated with supportive care and discharged in recovery after three weeks.
Subject(s)
Anemia, Hemolytic, Autoimmune/virology , Epstein-Barr Virus Infections/complications , Hepatitis, Viral, Human/virology , Adolescent , Anemia, Hemolytic, Autoimmune/diagnosis , Anemia, Hemolytic, Autoimmune/therapy , Epstein-Barr Virus Infections/diagnosis , Epstein-Barr Virus Infections/therapy , Female , Hemoglobinuria, Paroxysmal/diagnosis , Hemoglobinuria, Paroxysmal/therapy , Hemoglobinuria, Paroxysmal/virology , Hepatitis, Viral, Human/diagnosis , Hepatitis, Viral, Human/therapy , Herpesvirus 4, Human/isolation & purification , HumansABSTRACT
Headache is an increasingly common symptom among children and adolescents with a prevalence of 58.4%, and it may have profound impact on everyday life. A poorer prognosis is seen for children, who are not referred to specialist care, and long-term follow-up is shown to indicate a better outcome. A thorough headache history and a full neurological examination is vital to a correct diagnosis. The acute and prophylactic treatment is poorly studied, but acetaminophen and ibuprofen are first-line choices in acute treatment, and prophylactic treatment should be carried out by specialists.
