Infectious mononucleosis

Chervenick, Paul A.

doi:10.1016/s0011-5029(74)80012-x

Cited by 7 publications

(9 citation statements)

References 52 publications

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“…Headache is a common and well-studied symptom of EBV-IM. The prevalence of headache in patients with EBV-IM is reportedly 40e70% [11,12]. Sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of headache for diagnosis of EBV-IM have been estimated at 60e66%, 27e55%, 1.11e1.30, and 0.63e0.73, respectively [13,14].…”

Section: Discussionmentioning

confidence: 99%

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

Sasaki

Ishii

Maeda

et al. 2020

Journal of Infection and Chemotherapy

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Introduction: There are few studies on sex difference in patients with infectious mononucleosis caused by Epstein-Barr virus (EBV-IM). We performed a retrospective study to evaluate the sex difference in clinical presentation of patients with EBV-IM. Methods: We performed a single-center retrospective study evaluating >14-year-old patients with serologically confirmed EBV-IM during 2006e2017. We compared the patients' age, symptoms, physical findings, and laboratory data between male and female patients. To adjust for confounding factors, we performed a logistic regression analysis based on the results of univariate comparisons. Result: Of the 122 eligible patients (56 male and 66 female, ratio: 1:1.2), the median ages were 26 years old (interquartile range [IR], 22e31.5 years old]) and 22 years old (IR, 20e25 years old) for males and females, respectively (p < 0.001). Headache was significantly more prevalent in males (25.0% vs. 10.6%, p ¼ 0.036). Leukocyte count was also significantly higher in males (11,400/mm 3 [IR, 7,600e14,100/mm 3 ] vs. 9,400/mm 3 [IR, 6,600e11,600/mm 3 ], p ¼ 0.021). The prevalence of periorbital edema (male: 3.6% vs. female: 18.1%, p ¼ 0.012) and severity of transaminase elevation were significantly higher in females. The regression analysis evaluating clinical characteristics of male patients showed that age >30 years old, headache, and leukocyte >11,000/mm 3 had high odds ratios. Conclusion: Our single-center retrospective study suggests that older age of onset, headache, and leukocytosis are more likely to be characteristics of male patients with EBV-IM. Our study also underscores the importance of periorbital edema as a clue for early diagnosis of EBV-IM, especially in female patients.

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Section: Discussionmentioning

confidence: 99%

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

Sasaki

Ishii

Maeda

et al. 2020

Journal of Infection and Chemotherapy

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“…The patients had a massive proliferation of tumour cells in the spleen, but only slight lymphadenopathy and blood lymphocytosis at diagnosis (6,10,20,23). The remissions developed several years after splenectomy and/or radiotherapy of the spleen (5,6,10,18,20), after which the patient had a long symptom-free survival.…”

Section: Discussionmentioning

confidence: 99%

“…However, a limited number of patients are reported in whom no or seemingly inadequate treatments were followed by remissions that were believed to be complete (3, 5, 6, 8-10, 15, 18, 20, 22). Twelve such patients had been treated with radiotherapy of the spleen (6,8,10,20), two patients with splenectomy (5, lo), and seven patients with low-dose chemotherapy (5,6,8,9,22) before entering remission. Six patients achieved their remission more than one year afier the cessation of therapy (5,6,9,18,20); another developed without treatment a transition of the leukaemia into a non-leukaemic solid lymphoma (9), and one entered remission without any therapy (2).…”

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confidence: 99%

Haematological Remission of Leukaemic Polymorphic Immunocytoma Following Splenectomy

Juliusson

Öst

Biberfeld

et al. 1986

Acta Pathologica Microbiologica Scandinavica Series A :Patholog

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remission of leukaemic polymorphic immunocytoma following splenectomy. Case report with longitudinal immunological and cytogenetic studies. Acta path. microbiol. immunol. scand. Sect. A, 94: 133-139, 1986, A 56-year old man with a Rai stage IV B-cell chronic lymphocytic leukaemia (polymorphic immunocytoma according to the Kiel classification) of pK-phenotype with a clonal chromosomal abnormality in cells from peripheral blood, bone marrow, and spleen is reported on. Following splenectomy (without further therapy) the blood lymphocytosis gradually decreased to normal and the patient entered a remission, assigned 42 months after splenectomy by immunological and cytogenetic studies that revealed no cells of clonal origin in blood or bone marrow. Utilizing cellular markers of clonality, we thus confirm that haematological remissions may follow splenectomy. A subsequently developed orbital lymphoma (without leukaemia) consisted of tumor cells derived from the initial leukaemia cell clone as indicated by their immune and cytogenetic phenotype. The case report is discussed in relation to previous reports on "spontaneous" remissions of lymphoid leukaemias.

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“…Primary Epstein-Barr virus infectious mononucleosis, subsequently referred to as mononucleosis, classically affects children and young adults [1,2]. The clinical signs at presentation include fever, pharyngitis, measles-like rash, jaundice, and enlarged posterior cervical lymph nodes, liver or spleen [1][2][3]. In previously healthy subjects, the condition typically resolves over a period of weeks [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Bilateral upper eyelid swelling (Hoagland sign) in Epstein–Barr infectious mononucleosis: prospective experience

et al. 2022

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Background The typical presentation of Epstein–Barr virus infectious mononucleosis includes fever, pharyngitis, measles-like rash, jaundice, and enlarged lymph nodes, liver, or spleen. A painless bilateral swelling of the upper eyelid, sometimes with drooping of the lateral aspect, may also occur. This sign, referred to as Hoagland sign, is not or only marginally mentioned in reviews and textbooks. Methods Between 2019 and 2021, two of us evaluated all subjects with a positive acute Epstein–Barr virus serology for the typical signs of mononucleosis and for the possible existence of the Hoagland sign. Results During the mentioned period, the diagnosis of mononucleosis was made in 26 (14 females and 12 males) subjects aged from 9.0 to 33 years. The initial presentation included fever in 24, enlarged cervical lymph nodes in 23, pharyngitis in 21, a palpable liver in 7, a palpable spleen in 7, jaundice in 2, and a measles-like rash in 2 cases. The Hoagland sign was noted in 14 cases. Patients with and without Hoagland sign did not significantly differ with respect to age and sex. Conclusions The Hoagland sign is an easily identifiable clinical sign that is common and likely helpful early in the course of Epstein–Barr virus infectious mononucleosis. There is a need to expand awareness of this sign among physicians.

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Infectious mononucleosis

Cited by 7 publications

References 52 publications

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

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

Haematological Remission of Leukaemic Polymorphic Immunocytoma Following Splenectomy

Bilateral upper eyelid swelling (Hoagland sign) in Epstein–Barr infectious mononucleosis: prospective experience

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