Clinical Report: Elevated Alanine Aminotransferase Levels in Pediatric Patients

Overview

This study investigates the relationship between alanine aminotransferase (ALT) levels and Epstein–Barr virus (EBV) DNA load in hospitalized pediatric patients with infectious mononucleosis.

Background

Infectious mononucleosis (IM) caused by Epstein–Barr virus (EBV) is common in children and often presents with hepatic involvement, indicated by elevated ALT levels. Understanding the factors associated with ALT elevation is crucial for clinical assessment and management of pediatric patients with EBV-related IM.

Data Highlights

Key Findings

• Higher EBV DNA load correlates with increased ALT levels in pediatric patients.
• Each 10-fold increase in EBV DNA is associated with approximately 38% higher ALT levels.
• Older children (≥6 years) have significantly higher odds of ALT elevation compared to younger children (<3 years).
• Female sex is associated with higher odds of ALT elevation compared to male sex.
• The association between EBV DNA load and ALT elevation is consistent across different age groups.

Clinical Implications

Clinicians should consider EBV DNA load, age, and sex when evaluating ALT levels in pediatric patients with infectious mononucleosis. These factors can help contextualize liver enzyme elevations during initial assessments.

Conclusion

The study examines the relationship between EBV DNA load, age, and sex in understanding ALT elevation in pediatric infectious mononucleosis.

Related Resources & Content

1. Frontiers in Pediatrics, 2026 -- Elevated Alanine Aminotransferase Levels in Hospitalized Children With Infectious Mononucleosis
2. Frontiers in Pediatrics — Serum beta-2 microglobulin as a diagnostic biomarker for pediatric Epstein–Barr virus infections: a retrospective study
3. Frontiers in Pediatrics — Diagnostic value of combined flow cytometry-based detection of peripheral blood lymphocyte subsets and cytokines for pediatric infectious mononucleosis
4. Infection — Exploring the Factors and Risks Associated with Pre-Chemotherapy Viremia in Pediatric Patients with Acute Lymphoblastic Leukemia
5. The Journal of Infectious Diseases — A Threshold in Anti–EBNA-1 Antibody Titers Distinguishes Salivary EBV Shedders From Nonshedders
6. About Infectious Mononucleosis (Mono) | EBV and Mono | CDC
7. Frontiers | Alanine Aminotransferase Elevation in Hospitalized Children With Infectious Mononucleosis: Independent Associations With Epstein-Barr Virus DNA Load, Age, and Sex