A Preschool Girl with Acute Pancreatitis Due to Epstein-Barr Virus Infection: A Case Report

Background: Acute pancreatitis (AP) is rare in childhood (<1% ). The incidence in USA is estimated at 3.6-13.2/100.000 children per year. Most common causes are trauma (10-40%) and biliary diseases (10-30%), while 13% of the cases remain idiopathic. Infections are less common (<10%). Signs and symptoms are upper abdominal pain (80-95%), nausea and vomiting (40-80%), grey turner sign (2%) and intense pain that often reflects on the back.

Objective: The presentation of AP in a preschool girl due to Epstein-Barr virus (EBV) infection.

Methods: A 4-year-old girl was brought to the Pediatric ER of our Hospital, due to hyperemesis (severe vomiting) from 5 days with diffused abdominal pain and low fever. The clinical examination revealed mild abdominal pain and sore throat. We conducted general laboratory examinations, as well as amylase in serum and urine. Furthermore, virology examinations (EBV, Cytomegalovirus, Rota virus, Hepatitis A virus) and abdomen ultrasonography took place.

Results: The laboratory testing revealed hyperamylasemia (234 IU/L) and amylasuria (2692 IU/L), hypertriglyceridemia (224 mg/dl), increased CRP (4.97 mg/dl, negative

Conclusion: AP is more common in children than previously thought. Upon careful assessment fewer cases are found to be idiopathic. The outcome of AP depends on co-morbid conditions. AP should not be ruled out from our differential diagnostic thinking in children with abdominal distress, especially in the presence of vomiting.