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PubMed1982

Placental and fetal pathology in infectious mononucleosis. A possible indicator for Epstein-Barr virus teratogenicity.

Placentae and membranes were studied microscopically in five cases of pregnancy interruption due to maternal infectious mononucleosis in the first 2 months of pregnancy. This viral disease, caused by Epstein-Barr virus and apparently rare in pregnancy, induced specific placental lesions. In the decidua, these lesions were manifested by perivasculitis and necrotizing deciduitis. The membranes exhibited slight to moderate chorionitis. In the villi, endovasculitis, perivasculitis, and occasional vascular obliteration were found, as well as mononuclear and plasma cell villitis, with many large atypical vacuolated cells resembling plasma cells. Three fetuses were studied, two of which exhibited myocarditis. The fact that there were placental lesions in all cases studied, and that two of the fetuses exhibited myocarditis, must stimulate further research concerning the possible teratogenicity of this virus in man.

Abortion, Therapeutic↗
PubMed1991

[Hepatitis by infectious mononucleosis].

Five adult patients presenting with clinical and laboratory manifestations of an acute hepatitis in the course of a hitherto undiagnosed infectious mononucleosis (IM) are reviewed. Chief complaints were intense malaise and prolonged fever (7 to 15 days prior to diagnosis). Serum aminotransferases were moderately raised in all patients; three patients had mild jaundice with a direct-reacting hyperbilirubinemia; 4 patients had an enlarged and tender liver. When making the differential diagnosis of causes of acute hepatitis, blood smear examination was crucial, showing atypical lymphocytes (Downey). The diagnosis of IM was confirmed by the demonstration of high serum titers of antibodies against Epstein-Barr virus, IgM class (4 patients) or heterophil antibodies (1 patient), plus peripheral lymph node enlargement (3 patients), splenomegaly (4 patients) and the time course of the disease. The relevance of blood smear examination as a practical tool in the diagnosis of causes of acute hepatitis is stressed.

Acute Disease↗
PubMed1991

Gastrointestinal motor dysfunction in acquired selective cholinergic dysautonomia associated with infectious mononucleosis.

This report documents the disturbance in gastrointestinal motor function in a patient with selective cholinergic dysautonomia that occurred following acute infectious mononucleosis. Apart from the gut, other organs affected included the pupils, sweat glands, lacrimal and salivary glands, and urinary bladder. Autonomic function tests showed the preservation of sympathetic adrenergic functions in contrast to the generalized involvement of postganglionic parasympathetic and sympathetic cholinergic nerves, including denervation hypersensitivity of the pupil and urinary bladder to exogenous cholinergic agonists. Cardiac and abdominal vagal responses were abnormal. Colon myenteric plexus ganglion cells were normal by morphological and immunohistochemical studies, suggesting that the selective cholinergic dysautonomia was the most likely pathophysiologic process responsible for the observed motility disorder. This study documents the occurrence of selective cholinergic dysautonomia following a viral illness, the importance of the extrinsic neural control on the motor function of the gastrointestinal tract, and the usefulness of combined motility and autonomic function testing in the evaluation of patients with symptoms suggestive of gut dysmotility.

Adult↗