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Abstract: Background: Liver involvement among patients with Epstein Barr Virus (EBV) infectious mononucleosis is frequently seen but is often not of clinical significance. A small subset of patients can experience jaundice with modest elevation of hepatic transaminases. When this presents in a patient with Hemoglobin SC (HbSC) disease it can pose a diagnostic quandary due to the overlapping hepatic abnormalities that can be seen with sickle cell disease.
Case Report: This case presents a 15-year-old male with HbSC disease that was admitted for fever and abdominal pain. The patient developed signs of cholestatic hepatitis which was subsequently attributed to EBV infectious mononucleosis.
Conclusions: Although liver involvement with EBV is usually mild, severe cases of jaundice and hepatitis can be seen. EBV should be included in the differential of any patient with sickle cell disease presenting with liver abnormalities.