an 8 years old girl complaining of high grade fever since 3 months associated with arthralgia, sore throat cholestatic juandice
on examination hepatosplenomegaly , mitral rugurge
investigations shows mild hypochromic anemia with thrombocytosis, ALT 66 AST 62 PA 80%
ESR 110/120 CRP +VE Autoimmmune markers -ve bilirubin 2.6, Bone marrow aspiration normal, typhoid and brucella -ve , blood culture -ve,EBV EBNA +VE ,VC IGg +VE, IGM VC -VE, LDH 503