Analysis Of Clinical, Haematological And Biochemical Parameters In Patients With Infectious Mononucleosis

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Primary infection with Epstein-Barr virus (EBV) usually occurs in early childhood and often does not present clinical symptoms. More than 90% of adults are infected with this virus. A primary infection that occurs in adolescence or adulthood is usually clinically presented as infectious mononucleosis with a triad of symptoms: fever, lymphadenopathy and pharyngitis. Our retrospective study included 51 patients with a median age of 17 (9-23) years and serologically confirmed infectious mononucleosis. All patients with infectious mononucleosis were treated at the Clinic for Infectious Diseases at the Clinical Center in Kragujevac during 2013. We analysed the clinical, haematological and laboratory parameters of patients. The aspartate-aminotransferase levels were increased in 40 patients, with a mean value of 116.24 (±93.22); the alanine-aminotransferase levels were increased in 44 patients, with a mean value of 189.24 (±196.69). Lymphadenopathy was the most common clinical feature upon admission in 49 patients (96%); 38 patients (74.5%) had splenomegaly, and 20 (39%) had hepatomegaly. Twenty-six patients (51%) had leukocytosis with lymphocytosis, while 15 (75%) of the 20 who had a normal leukocyte count also had lymphocytosis. In the present study, we updated the clinical, haematological and laboratory parameters, which may lead to the establishment of an accurate diagnosis and promote further treatment of the patients.

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  • 1. Brkić S Jovanović J Preveden T Vukobratov Z. Serološki profil Epstein–Barr virusne infekcije u akutnoj infektivnoj mononukleozi. Med Pregl. 2003; 56.1-2: 7-16.

  • 2. Mahmud I Abdel-Mannan OA Wotton CJ Goldacre MJ. Maternal and perinatal factors associated with hospitalised infectious mononucleosis in children adolescents and young adults: record linkage study. BMC Infect Dis. 2011; 11:51.

  • 3. Cohen JI. Epstein-Barr virus infection. N Eng J Med. 2000; 343: 481–92.

  • 4. Guerrero-Ramos A Patel M Kadakia K Haque T. Performance of the architect EBV antibody panel for determination of Epstein-Barr virus infection stage in immunocompetent adolescents and young adults with clinical suspicion of infectious mononucleosis. Clin Vaccine Immunol. 2014; 21(6): 817-23.

  • 5. Dimić E Jovanović J. Akutne infektivne bolesti. Novi Sad: Medicinski fakultet; 1995.

  • 6. Kofteridis PD Koulentaki M Valachis A et al. Epstein Barr virus hepatitis. Eur J Intern Med. 2011; 22(1): 73-6.

  • 7. Cohen JI. Harrison principles and practice of internal medicine. 14th ed. New York: Mc Graw-Hill; 1997.

  • 8. Čanović PS Gajović O Todorović Z Mijailović Z. Epstein-Barr virus hepatitis associated with icterus: A case report. Medicinski pregled. 2006; 59.3-4: 179-82.

  • 9. Đorđević M Simonović J Žerjav S Dokić Lj. Ikterični oblici primarne Epstein-Barr virusne infekcije - prikaz dva bolesnika. Acta Inf Yu. 2001; 6: 317-21.

  • 10. Mandel GL Douglas RC Bennett JE. Principles and practice of infectious diseases. 4th ed. New York; 1995.

  • 11. Katon W Russo J Ashley RL Buchwald D. Infectious mononucleosis: psychological symptoms during acute and subacute phases of illness. General hospital psychiatry. 1999; 21.1: 21-9.

  • 12. Yang SI Geong JH Kim JY. Clinical Characteristics of Primary Epstein Barr Virus Hepatitis with Elevation of Alkaline Phosphatase and γ-Glutamyltransferase in Children. Yonsei medical journal. 2014; 55.1: 107-12.

  • 13. Finkel M Parker GW Fanselau HA. The hepatitis of infectious mononucleosis: experience with 235 cases. Mil Med. 1964; 129: 533–8.

  • 14. Mandell Douglas. Bennett’s principles and practice of infectious diseases. 6th ed. Philadelphia: Elsevier Churchill Livingston; 2005.

  • 15. Horwitz CA Burke D Grimes P Tombers J. Hepatic function in mononucleosis induced by Epstein–Barr virus and cytomegalovirus. Clin Chem. 1980; 26: 143–6.

  • 16. Feranchak AP Tyson RW Narkewicz MR Karrer FM Sokol RJ. Fulminant Epstein– Barr viral hepatitis: orthotopic liver transplantation and review of the literature. Liver Transplant Surg. 1998; 4: 469–76.

  • 17. Vine LJ Shepherd K Hunter JG et al. Characteristics of Epstein-Barr virus hepatitis among patients with jaundice or acute hepatitis. Aliment Pharmacol Ther. 2012; 36: 16-21.

  • 18. Vento S Guella L Mirandola F et al. Epstein-Barr virus as a trigger for autoimmune hepatitis in susceptible individuals. Lancet. 1995; 346(8975): 608-9.

  • 19. Jenson BH. Epstein - Barr virus. Pediatrics in Review. 2011; 32; 375-85.

  • 20. Grotto I Mimouni D Huerta M et al. Clinical and laboratory presentation of EBV positive infectious mononucleosis in young adults. Epidemiol Infect. 2003; 131(1): 683-9.

  • 21. Wang Y Li J Ren YY Zhao H. The levels of liver enzymes and atypical lymphocytes are higher in youth patients with infectious mononucleosis than in preschool children. Clinical and Molecular Hepatology. 2013; 19: 382-8.

  • 22. Ostler HB Thygeson P. The Ocular Manifestations of Herpes Zoster Varicella Infectious Mononucleosis and Cytomegalovirus Disease. Surv Ophthalmol. 1976; 21(2): 148-59.

  • 23. Maichuk IF: The conjunctiva virus eye disease: agents and clinical forms. Bull Ophthalmol Soc Egypt. 1974; 67: 1-28.

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