Infectious mononucleosis and hepatic function

Abstract

Abnormal hepatic function is common in infectious mononucleosis (IM). However, it remains unknown why increased transferase levels are more common than bilirubin abnormalities in IM. The current study aimed to investigate these associations in the Chinese population. A total of 95 patients with IM (47 males and 48 females) were enrolled in the current study, as well as 95 healthy controls. Patients were sorted by sex. A receiver operating characteristic (ROC) curve was used to determine cut-off values for IM diagnosis and prediction. Crude and adjusted odds ratios (OR) for IM were analyzed using binary logistic regression. It was determined that alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT) levels were significantly higher in patients with IM compared with controls; however, total bilirubin (TB) levels were significantly lower in patients with IM. ROCs demonstrated that, if ALT, AST and GGT concentrations were higher than, or if TB was lower than, cut-off values, they were predictive of IM. Binary logistic regression identified that the risk of IM in patients exhibiting high levels of transferases was significantly increased, particularly in males. Crude ORs in ALT quartile 4 were 21.667 and 10.111 for males and females, respectively and adjusted ORs were 38.054 and 9.882, respectively. A significant IM risk of IM was evident in patients with low bilirubin levels and females appeared to be particularly susceptible. For example, crude ORs in quartile 1 were 8.229 and 8.257 for males and females, respectively and adjusted ORs were 8.883 and 10.048, respectively. Therefore, the current study identified a positive association between transferase levels and IM and a negative association between TB and IM. Therefore, the results of the current study indicate that high transferases are suggestive of IM, particularly in males, whereas low TB is suggestive for IM, particularly in females.

Sex difference in clinical presentation of patients with infectious mononucleosis caused by Epstein-Barr virus

“…The gender ratio of patients with EBV-IM, as high as 1:1.2 in this study, was also compatible with that of previous studies, which concluded that there was no apparent gender predisposition [1,2]. On the other hand, sex differences in transaminase elevation are incompatible with findings of a previous study, which reported that transaminase elevation in patients with EBV-IM was more remarkable in males [4]. Because females are considered more susceptible to alcohol and acetaminophen [26,27], we also evaluated alcohol consumption and recent exposure to drugs such as acetaminophen.…”

“…IM associated with EBV (EBV-IM) typically causes fever, pharyngitis, lymphadenopathy, and hepatitis in young male and female patients [1,2]. Previous studies on sex difference in patients with EBV-IM revealed higher age of onset [3] and remarkable elevation of transaminase in males [4] and a higher prevalence of persistent fatigue after onset of EBV-IM in female patients [5]. However, studies on sex difference in clinical symptoms and signs are sparse.…”

Gene EBNA3C: Type of Infection by EBV (EBV1 and EBV2) Correlation With Clinical and Biochemical Parameters (AST, ALT and GGT) in Individuals With Infectious Mononucleosis in the Metropolitan Area of Belém, Pará, 2005-2016

“…When compared to the EBV types (EBV1, EBV2 and EBV1/2), our results were statistically significantly correlated with the age group and AST and ALT values (p <0.005). Similar data were cited by Zhang et al (2018), who reported that ALT, AST and GGT levels were significantly increased in cases of infectious mononucleosis compared to controls, indicating that transferase levels can be used to diagnose and treat as a risk alert for the infection caused by MI [34].…”

“…Ninety-five patients with infectious mononucleosis and 95 healthy controls were analyzed for AST, ALT and GGT; alterations were elevated in patients with infectious mononucleosis compared to the controls [34].…”

Lepedékes tonsilla gyermekkorban. Hogyan csökkenthető az indokolatlan antibiotikumfelhasználás?

“…A mononucleosis infectiosa szindróma (láz, nyaki lympha denomegalia, tonsillitis) hátterében az esetek 90%ában az EBV kóroki szerepe igazolható, ugyanakkor egyéb vírusok is okozhatnak hasonló klinikai tüneteket. EBV fertőzés során laborvizsgálattal a betegek több mint 80%ában emelkedett transzaminázértékek mutathatók ki, melyek általában 20 napon belül normalizálódnak [10,11]. Az emelkedett transzaminázértékek kifejezett periportalis lymphocytainfiltratióval, Kupffersejtaktivi tással és a májsejtek jelentős acidofildegenerációjával hozhatók összefüggésbe, a fertőzésre adott szisztémás válasz részjelenségeként [11].…”