Evaluation of Lipid Profile Changes in Pediatric Patients with Acute Mononucleosis

Sayyahfar, Shirin; Lavasani, Amin; Nateghian, Alireza; Karimi, Abdollah

doi:10.3947/ic.2017.49.1.44

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…More recently, Apostolou et al found atherogenic lipid changes in 29 patients with infectious mononucleosis; an increase in serum triglyceride concentrations was associated with an increase in the concentrations of apolipoprotein C-III, which is an inhibitor of lipoprotein lipase [22]. Likewise, Sayyahfar et al reported transient hypertriglyceridemia in 36 children with infectious mononucleosis [23]. In this article, we report on an adult patient with extreme hypertriglyceridemia during infectious mononucleosis.…”

Section: Introductionmentioning

confidence: 61%

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Hypertriglyceridemia during infectious mononucleosis

Páez-Guillán

Franco

Alende-Sixto

et al. 2021

Preprint

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Background Hypertriglyceridemia can be observed in lymphoproliferative disorders. Epstein-Barr virus-induced infectious mononucleosis can be considered a self-limiting lymphoproliferative disorder. The aim of this study is to investigate serum triglyceride concentrations, associated factors, and time-course changes in patients with infectious mononucleosis. Methods We report on an adult patient with extreme hypertriglyceridemia (triglycerides > 1000 mg/dL) during infectious mononucleosis. We then reviewed the clinical records of 360 patients admitted to the hospital due to infectious mononucleosis (median age 19 years, range 15–87 years; 51.4% male). Serum triglyceride concentrations were compared with those of a control sample from the general population, aged 18–30 years (n = 75). A second measurement of serum triglyceride concentrations, obtained during convalescence (median of 30 days after the initial determination), was available for 160 patients. Results Triglyceride concentrations in the acute phase (median 156 mg/dL; range, 27–452 mg/dL) were significantly higher than those of controls (P < 0.001). A total of 194 patients (53.9%) showed hypertriglyceridemia (triglycerides > 150 mg/dL), which was more common in the older patients. A significant correlation was observed between serum triglycerides and white blood cell counts, total cholesterol levels, and markers of liver damage. Serum triglyceride concentrations tended to decrease during convalescence (P < 0.001) and were lower than the initial measurement in 83.7% of the cases. Conversely, total serum cholesterol concentrations during the acute phase were lower than those of the controls and increased during convalescence (P < 0.001). Conclusions Patients with severe (in-hospital) infectious mononucleosis frequently show mild, transient hypertriglyceridemia. Further studies are needed to elucidate the mechanisms underlying these findings.

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Section: Introductionmentioning

confidence: 61%

“…The lipid paradox is not limited to lymphoproliferative and hemophagocytic syndromes but is also observed in other immunebased disorders [19,20]. [23]. In this article, we report on an adult patient with extreme hypertriglyceridemia during infectious mononucleosis.…”

Section: Introductionmentioning

confidence: 85%

Hypertriglyceridemia during infectious mononucleosis

Páez-Guillán

Franco

Alende-Sixto

et al. 2021

Preprint

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“…Epstein–Barr virus infection leads to an increase in blood triglyceride levels, which is considered to be strongly associated with systemic immune inflammation in addition to being associated directly with liver function impairment. Similarly, Sayyahfar et al found elevated blood triglyceride levels in patients with acute EBV infection, possibly because changes in blood triglyceride levels and lipoprotein metabolism during infection led to anti‐inflammatory effects, thereby contributing to host defense, and such changes were a part of the acute phase response of the innate immune system 23 . In some children with acute EBV infection, elevated blood triglyceride levels recovered 2 months after the infection, and most lipid metabolism abnormalities recovered 4 months after the infection.…”

Section: Discussionmentioning

confidence: 95%

“…Similarly, Sayyahfar et al found elevated blood triglyceride levels in patients with acute EBV infection, possibly because changes in blood triglyceride levels and lipoprotein metabolism during infection led to anti-inflammatory effects, thereby contributing to host defense, and such changes were a part of the acute phase response of the innate immune system. 23 In some children with acute EBV infection, elevated blood triglyceride levels recovered 2 months after the infection, and most lipid metabolism abnormalities recovered 4 months after the infection. Blood triglyceride levels may be used as an indicator of recovery from EBV infection.…”

Section: Discussionmentioning

confidence: 98%

Risk factors for persistent fever in children with infectious mononucleosis

Zhou

Cao

Deng

2023

Pediatrics International

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BackgroundFever is a common symptom in children with infectious mononucleosis (IM). However, the significance of the duration of a fever is poorly understood. This study aimed to analyze the risk factors for persistent fever in children with IM.MethodsPatients diagnosed with IM (aged <18 years; except those with concomitant hematological malignancies or tumor diseases) in a high‐volume academic hospital in 2019 were reviewed from a prospectively maintained database. Children with transient fever (≤7 days) were compared with those with persistent fever (>7 days). The risk factors for persistent fever in children with IM were examined using binary logistic regression. Furthermore, the predictive ability of these risk factors was assessed and presented using a receiver operating characteristic (ROC) curve.ResultsOf the 184 children included in this study, 131 (71.96%) belonged to the transient fever group and 53 (28.04%) belonged to the persistent fever group (median age: 49 and 64 months, respectively; p = 0.093). Statistical significance was observed in hepatomegaly, alanine aminotransferase level, blood triglyceride level, and blood Epstein–Barr virus polymerase chain reaction (EBV‐PCR) copy number (all p < 0.05). Binary logistic regression revealed that high blood triglyceride level was the risk factor for persistent fever in children with IM. High blood triglyceride level predicted persistent fever duration with an area under the ROC curve of 0.73 and an optimal cutoff value of 1.315 mmol/L.ConclusionHigh blood triglyceride level was the risk factor for persistent fever in children with IM. Thus, children with elevated levels of blood triglycerides need additional care. To diagnose IM, a blood EBV‐PCR is more useful than a throat‐swab EBV‐PCR.

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“…More recently, Apostolou et al observed atherogenic lipid changes in 29 patients with infectious mononucleosis, such as increased serum triglyceride (TG) concentrations [ 7 ]. Likewise, Sayyahfar et al reported transient hypertriglyceridemia in 36 children with infectious mononucleosis [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Transient hypertriglyceridemia: a common finding during Epstein-Barr virus-induced infectious mononucleosis

et al. 2021

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Background Hypertriglyceridemia can occur in lymphoproliferative disorders. Infectious mononucleosis is a self-limiting, benign lymphoproliferative disorder. This study aimed to investigate the serum triglyceride concentrations and their change over time in patients with infectious mononucleosis. Methods We evaluated an adult patient with severe hypertriglyceridemia (>1000 mg/dL) during infectious mononucleosis and reviewed the records of 360 patients admitted to our hospital because of infectious mononucleosis (median age, 19 years; range, 15-87 years; 51.4% male). We compared the serum triglyceride concentrations with those of a control sample from the general population (n=75). A second triglyceride measurement, obtained during convalescence (median of 30 days after the initial determination), was available for 160 patients. Results The triglyceride concentrations in the acute phase (median: 156 mg/dL) were significantly higher than those of the controls (median, 76 mg/dL; P<0.001). A total of 194 (53.9%) patients presented with hypertriglyceridemia (>150 mg/dL), which was more common in the patients older than 30 years than in the younger patients (78.6% vs. 50.6%; P<0.001). A significant correlation (P<0.005) was observed between the triglyceride levels and white blood cell counts, total cholesterol levels, and liver damage markers. The triglyceride concentrations decreased during convalescence (P<0.001) and were lower than the initial measurement in 83.7% of the cases. Conversely, the total cholesterol concentrations during the acute phase were lower than those of the controls and increased during convalescence (P<0.001). Conclusions Patients with severe infectious mononucleosis frequently show mild, transient hypertriglyceridemia. Further studies are needed to elucidate the mechanisms underlying this finding.

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Evaluation of Lipid Profile Changes in Pediatric Patients with Acute Mononucleosis

Cited by 5 publications

References 16 publications

Hypertriglyceridemia during infectious mononucleosis

Hypertriglyceridemia during infectious mononucleosis

Risk factors for persistent fever in children with infectious mononucleosis

Transient hypertriglyceridemia: a common finding during Epstein-Barr virus-induced infectious mononucleosis

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