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PubMed1983

HLA-AB and -DR types in patients with infectious mononucleosis (IM).

The frequency of HLA-A, -B and -DR antigens in 48 infectious mononucleosis (IM) patients was studied and the antigen frequencies were compared with those of a local panel. The resulting data do not confirm the association of IM and HLA-B35 as reported in a previous work. A high and significant frequency of blank HLA-DR phenotypes was noticed in IM population during the acute phase, but HLA-DR phenotypic expression was restored after recovery. This lack of expression could be the result of modified HLA-DR expression on circulating EBV infected B lymphocytes.

Adolescent↗
PubMed1978

Jaundice and infectious mononucleosis in Ghana.

A total of 715 sera from jaundiced cases were examined for Infectious Mononucleosis (IM) antibodies and 5.03% were found to be positive. It was further found that the incidence of IM antibodies in the study population increased with age, the incidence being most prevalent amongst the 11-20 year age-group. IM antibodies with jaundice were found to be most prevalent in the Volta and Eastern Regions, i.e. amongst populations of the coastal-lowland-swampy-shrubland zone of the country, particularly during the dry season which stretches from October through March. A preponderance of IM antibodies amongst females of the age-group 11-20 years was recorded. The possible mode of IM transmission in the tropical setting, with particular reference to Ghana, is proposed.

Adolescent↗
PubMed1992

Acute tonsillectomy in the management of infectious mononucleosis.

Life-threatening upper airway obstruction can be caused by tonsillopharyngitis secondary to infectious mononucleosis (IM). The administration of corticosteroids, emergency tracheostomy and acute tonsillectomy have been advocated as ways of managing this problem. In a series of 25 patients admitted over a five-year period with IM, 15 were judged to have symptoms severe enough to warrant the administration of corticosteroids. Six of these 15 patients had little improvement in their condition and thus underwent acute tonsillectomy. There were no significant complications of this surgery. A further three patients who received corticosteroids required tonsillectomy for recurrent tonsillitis later in the study period. By contrast, only one of the ten patients who did not receive corticosteroids subsequently required tonsillectomy. Acute tonsillectomy is of value in selected cases of IM tonsillopharyngitis. It may decrease the morbidity of recurrent tonsillitis after IM, in addition to averting the immediate risk of respiratory obstruction.

Acute Disease↗
PubMed1982

Infectious mononucleosis in an adult progressing to fatal immunoblastic lymphoma.

We report a case of infectious mononucleosis progressing to fatal immunoblastic lymphoma. The patient, a 44-year-old man who may have had an immunoregulatory defect, failed to have an appropriate T-cell response to his Epstein-Barr (EB) viral infection. His active EB viral infection was manifest by seroconversion of IgM-viral capsid antibody and a greater than four fold rise in IgG-viral capsid antibody. Also, he transmitted his EB viral infection to his wife who became ill 1 month after his death. Clinically the patient's illness was characterized by waxing and waning lymphadenopathy, persistent fever, diarrhea (similar to that associated with cholera), a coagulopathy, and gastrointestinal bleeding. The patient had pathologic findings of a diffuse immunoblastic lymphoma involving lymph nodes, small bowel, liver, pancreas, kidneys, lungs, and bone marrow. Immunologic cell markers showed the tumor to be polyclonal.

Adult↗
PubMed1997

Strict lymphotropism of Epstein-Barr virus during acute infectious mononucleosis in nonimmunocompromised individuals.

Previous investigations of exfoliated oropharyngeal cells from individuals suffering from infectious mononucleosis (IM) suggested that the oropharyngeal epithelia are the primary target and also the site of life-long persistence of the Epstein-Barr virus (EBV). This concept was widely accepted. However, the investigation of histological sections with more sensitive EBV detection techniques has drawn this concept into doubt since EBV proved to be constantly absent in normal epithelial cells. To elucidate the discrepancy, throat washings and peripheral mononuclear blood cells from 16 patients suffering from IM were investigated for EBV-DNA and EBV gene products employing highly sensitive in situ hybridization, immunocytochemistry, and polymerase chain reaction. Although all patients exhibited latently infected B lymphocytes in peripheral blood, samples of exfoliated oropharyngeal cells were constantly EBV-negative with the exception of three cases. In these cases, the patients additionally suffered from purulent ulcerating tonsillitis, EBV-infected B cells, but no EBV-infected epithelial cells were detectable. These findings support the view that recirculating lymphocytes of B-cell origin, but not epithelial cells are the initial target of EBV during primary infection and that B cells also represent the site of life-long viral persistence.

Adolescent↗
PubMed1975

Infectious mononucleosis: model for self-limiting lymphoproliferation.

Evidence for the extensive lymphoproliferation which characterises infectious mononucleosis (I.M.) is summarised, and some of the mechanisms which are though to control lymphoproliferative activity in this disease are discussed. The main host responses which appear to limit lymphoproliferation in I.M. include the development of humoral antibodies against the Epstein-Barr (E.B.) virus-associated membrane antigen (present on the E.B. viral envelope and on E.B.-virus-infected cells) and cellular immune responses directed against E.B.-virus-containing lymphocytes. Recent evidence is reviewed which indicates that E.B. virus preferentially infects B lymphocytes and that these E.B.-virus-containing cells, which are altered antigenically, evoke a massive response in the host T cells which do not carry E.B. virus; in the presence of E.B.-virus-infected B cells, T cells are transformed and become cytotoxic for B cells. Some of the general implications of the predominant T-cell response in I.M. are discussed with particular relation to autoantibody formation and antigenic competition. The possible role of the distinctive heterophil antigens and antibodies in determining the self-limiting course of I.M. is briefly considered. The general status of I.M. as a self-limiting, albeit intense, lymphoproliferative disease is appraised and the tenuous relationship between I.M. and irreversible lymphoproliferative states is discussed.

Antibodies, Heterophile↗
PubMed1968

Relation between Epstein-- Barr viral and cell membrane immunofluorescence in Burkitt tumor cells. II. Comparison of cells and sera from patients with Burkitt's lymphoma and infectious mononucleosis.

Blastoid cell cultures derived from leukocytes of patients in the acute stage of infectious mononucleosis (IM) and harboring Epstein-Barr (EB) virus in at least 1% of the cells were found to possess antigens in their membranes which presently are indistinguishable from those detected in Burkitt's lymphoma (BL) cells by the techniques employed. It was noted that, in the course of IM, antibodies are formed which react in indirect immunofluorescence tests with membrane antigens of live cells from Burkitt tumor lines as well as from IM leukocyte cultures, including an autochthonous line in the case of one patient. Sets of sera from IM patients were tested which included a serum collected weeks to years before onset of illness. In the majority of these the pre-IM serum failed to react in membrane immunofluorescence (MIF) tests with any of several Burkitt tumor cell lines employed, but in some cases the presera reacted with cells of some but not others of the lines. Possible explanations for these discrepant results have been discussed. The antibodies involved in the MIF test are evidently distinct from those responsible for the EBV and heterophile reactions. Maximal MIF activity is attained long after the other two antibodies have reached maximal titers and antibodies to EBV and membrane antigens seem to persist for years whereas the heterophile reaction turns negative within a few months.

Antibodies↗
PubMed2005

Risk and predictors of fatigue after infectious mononucleosis in a large primary-care cohort.

BACKGROUND: Fatigue has been found to complicate infectious mononucleosis (IM) when patients are directly asked about it. We do not know whether such fatigue is clinically significant, nor whether IM is a specific risk for fatigue (or whether it can follow other common infections). Various risk markers for post-infectious fatigue have been identified, but findings are inconsistent. AIM: To determine the risk of clinically reported fatigue (compared with depression) after IM (compared with both influenza and tonsillitis) in patients attending primary care, and to examine risk markers for post-IM fatigue. DESIGN: Comparison of matched primary-care cohorts. METHODS: We identified 1438 adult patients with a positive heterophil antibody test for IM from the UK General Practice Research Database. These patients were individually matched on age, sex and practice to two comparison groups; one with a clinical diagnosis of influenza and the other of tonsillitis. RESULTS: The odds ratios (ORs) (95%CI) for reported fatigue after IM vs. influenza and tonsillitis were 4.4 (2.9-6.9) and 6.6 (4.2-10.4), respectively. Risk markers for post-IM fatigue included female sex and premorbid mood disorder. By comparison, the ORs for depression after IM vs. influenza and tonsillitis were 1.6 (0.9-2.6) and 2.3 (1.4-3.9), respectively. DISCUSSION: IM is a specific and significant risk for clinically reported fatigue, which is both separate from, and more common than, depression. Female sex and premorbid mood disorder are risk markers for fatigue. These can be used both to target prevention strategies and to explore aetiological mechanisms.

Adolescent↗
PubMedDate not supplied

[Bilateral extrinsic ophthalmoplegia in infectious mononucleosis].

The AA. describe an eight years old child with extrinsic bilateral ophthalmoplegia associated with infectious mononucleosis. On the right (eye) a compromise of the VI (partial) and the III (total) pairs of cranial nerves was evident. On the left all extrinsic oculomotor nerves were interested.

Child↗
PubMed1974

Observations on the type of infection by Epstein-Barr virus in peripheral lymphoid cells of patients with infectious mononucleosis.

Transformation to continuous cell lines has been studied in cultures of peripheral leuckocytes from infectious mononucleosis (IM) patients and in co-cultures of IM leukocytes and foetal cord blood leukocytes of opposite sex. The transformed cells in the co-cultures were of mixed origin with foetal cells usually predominating. Neutralizing antisera to EB virus markedly reduced or abolished the incidence of transformation in IM leukocyte cultures. This effect was not due to cytotoxicity and followed the pattern seen with cultures where transformation was known to depend on the inter-cellular transfer of infectious EB virus. The findings suggest that EB virus is harboured in peripheral lymphocytes of IM patients as a non-productive unexpressed infection which is activated to produce virus in vitro, the particles released then infecting neighbouring cells to give transformed lines. The differences between this mechanism and the one whereby lines arise in culture from malignant cells of Burkitt's lymphoma are considered, and their significance is discussed.

Blood↗
PubMed1997

[Spontaneous rupture of the spleen and infectious mononucleosis].

The authors report the case of a 19-year-old patient with an infectious mononucleosis, causing, 2 days after the onset of symptoms, a spontaneous splenic rupture. Acetyl salicylic acid had been given at the beginning of symptoms including fever and a pharyngitis. The diagnosis was obtained by laparoscopy after failure of sonographic. The patient was discharged 10 days after splenectomy.

Abdomen, Acute↗
PubMed1983

Auto-rosette formation in the peripheral blood of a patient with infectious mononucleosis.

Auto-rosette formation by peripheral blood lymphocytes was observed in a patient with infectious mononucleosis (IM), with the scanning electron microscope (SEM). The red blood cells adhered to lymphocytes with numerous microvilli on their surface. This phenomenon was observed only during the acute stage of the disease and not in the recovery period. Auto-rosette formation was detected neither in 7 other patients with IM, nor in control subjects.

Child↗
PubMed1979

Infectious mononucleosis with severe neutropenia and opsonic antineutrophil activity.

Severe granulocytopenia is an uncommon complication of infectious mononucleosis, only 18 cases having been reported previously. Our review and experience with this case would indicate that (1) severe granulocytopenia is usually diagnosed at about the third or fourth week of illness, (2) bone marrow examination most commonly reveals lack of mature neutrophil precursors in the myelocytic series, (3) the duration of usually short, lasting about a week, and (4) most patients recover without treatment. The laboratory findings in our case suggests that the neutropenia may be antibody mediated.

Adolescent↗
PubMed2005

[Infectious mononucleosis].

The primary infection with Epstein-Barr virus in an immunocompetent individual leads to infectious mononucleosis with symptoms of diphtheroid angina, lymph node swelling in the neck and hepatosplenomegaly. The most common age of infection lies between 15 and 25 years. The illness can affect a number of organs simultaneously and thus requires interdisciplinary diagnostics. For differential diagnosis, a differential blood analysis and a EBV quick test are required. The presence of IgM antibodies demonstrates the presence of the infection. Ultrasound of the abdomen can be made to determine the involvement of additional organs. In most cases, recovery occurs without complications. Acute cases can usually be handled successfully with medication. If symptomatic treatment fails, pharyngeal airway obstruction is possible and a tonsillectomy may be necessary. Otherwise, surgical treatment is obsolete. Generally, the prognosis is good. Severe courses and complications are rare.

Humans↗