Acute acalculous cholecystitis in children with Epstein-Barr virus infection: a role for Gilbert's syndrome?
«Acute acalculous cholecystitis (AAC) in association with acute Epstein-Barr virus (EBV) infection has rarely been described in childhood. In the literature, there are only four reported pediatric cases of AAC associated with isolated primary EBV infection. We present two cases (one new, one retrospectively reviewed) of children with Gilbert's syndrome (GS) who presented with AAC during the course of primary EBV infection. Antibiotics were not used and AAC subsided gradually as the infection regressed. The co-occurrence of GS might have played a contributory role in the pathogenesis of AAC during acute EBV infection.»
Acalculous cholecystitis during the course of acute Epstein-Barr virus infection and Gilbert's syndrome.
We think that if the hypothesis of Attilakos et al. were true, many more cases of AAC would have occurred in patients with GS, and GS would probably already have been considered a risk factor for cholecystitis independently from an EBV infection. On the contrary, a MEDLINE search combining the term ‘Gilbert’ AND ‘cholecystitis’ yields only four papers and in none of them is an association between GS and cholecystitis considered.