Hypertriglyceridemia during infectious mononucleosis

Abstract

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.