scholarly journals A typical Presentation of Acute Infectious Mononucleosis (AIM) with Isolated Hyperbilirubinemia

2019 ◽  
pp. 152-154
Author(s):  
Asim Kichloo ◽  
Michael Aljadah ◽  
Shakeel M Jamal ◽  
Navya S Vipparla
Keyword(s):  
Hepatocellular Carcinoma ◽  
Autoimmune Hepatitis ◽  
Sore Throat ◽  
Infectious Mononucleosis ◽  
Alcoholic Hepatitis ◽  
Epstein Barr Virus ◽  
Physical Exam ◽  
Barr Virus ◽  
Epstein Barr ◽  
Acute Infectious Mononucleosis

Epstein - Barr virus (EBV) induced hepatitis and subsequent hyperbilirubinemia is a strikingly rare cause of jaundice. Lack of other common infectious mononucleosis symptoms makes the diagnosis difficult with history and physical exam alone. With differential diagnoses more commonly including HAV, HCV, and HBV hepatitis infections; alcoholic hepatitis; autoimmune hepatitis; and hepatocellular carcinoma, suspicion for EBV induced hepatitis is often low. We present a noteworthy case of isolated hyperbilirubinemia due to EBV virus confirmed with biopsy, without other infectious mononucleosis symptoms such as fever, sore throat, or splenomegaly. Furthermore, we review the pathophysiology, diagnosis, treatment, and prognosis of EBV-induced hepatitis.

scholarly journals Erratam: Epstein-Barr virus BZLF1 gene promoter variants in pediatric patients with acute infectious mononucleosis. Its comparison with pediatric lymphomas

2012 ◽  
Vol 84 (10) ◽  
pp. 1697-1697
Author(s):  
Mario Alejandro Lorenzetti ◽  
Marina Inés Gutiérrez ◽  
Jaime Altcheh ◽  
Guillermo Moscatelli ◽  
Samanta Moroni ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Pediatric Patients ◽  
Gene Promoter ◽  
Barr Virus ◽  
Bzlf1 Gene ◽  
Epstein Barr ◽  
Acute Infectious Mononucleosis

scholarly journals Plasmacytic differentiation of circulating Epstein-Barr virus-infected B lymphocytes during acute infectious mononucleosis.

1981 ◽  
Vol 153 (2) ◽  
pp. 235-244 ◽  
Author(s):  
J E Robinson ◽  
D Smith ◽  
J Niederman
Keyword(s):  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Plasma Cells ◽  
Phase 1 ◽  
Acute Disease ◽  
Nuclear Antigen ◽  
Barr Virus ◽  
Infected Cells ◽  
Epstein Barr ◽  
Acute Infectious Mononucleosis

During the acute phase (1 wk of symptoms or less) of infectious mononucleosis (IM), 70--80% of circulating Epstein-Barr virus nuclear antigen (EBNA)-positive cells have differentiated toward plasma cells. Thus the characteristics of the infected cells in the majority of IM patients during early disease are indistinguishable from EBNA-positive tumor cells of a previously reported child who developed lymphoma during IM. IgA and IgG were the most frequent and IgM the least frequent immunoglobulin isotypes detected in EBNA-positive cells. In acute disease EBNA was present in 5.5--20% of T cell-depleted blood lymphocytes but in the 2nd or 3rd wk of illness the number of EBNA-positive cells sharply decreased to 0.4--1.4%. At the same time the fraction of antigen-positive cells containing cytoplasmic immunoglobulins also diminished, suggesting either that differentiation of infected cells was altered during the disease or that nondifferentiated antigen-positive cells had a survival advantage. Both the high proportion of plasmacytic EBNA-positive cells seen during acute disease and the apparent loss of differentiation by these cells later in disease may be regulated by host immunologic factors. Immunoglobulin-producing EBNA-positive cells may be the source of heterophile antibodies and other seemingly inappropriate antibodies usually found in serum during IM; however, increased numbers of noninfected plasma cells were present in some patients and may also be a potential source of these unusual antibodies.

Identification of Epstein-Barr virus-infected cells in tonsils of acute infectious mononucleosis by in situ hybridization

1989 ◽  
Vol 20 (8) ◽  
pp. 796-799 ◽  
Author(s):  
G. Niedobitek ◽  
S. Hamilton-Dutoit ◽  
H. Herbst ◽  
T. Finn ◽  
M. Vetner ◽  
...  
Keyword(s):  
In Situ Hybridization ◽  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Barr Virus ◽  
Infected Cells ◽  
Epstein Barr ◽  
Acute Infectious Mononucleosis

Epstein-Barr virus BZLF1 gene promoter variants in pediatric patients with acute infectious mononucleosis: Its comparison with pediatric lymphomas

2009 ◽  
Vol 81 (11) ◽  
pp. 1912-1917 ◽  
Author(s):  
Mario Alejandro Lorenzetti ◽  
Marina Inés Gutiérrez ◽  
Jaime Altcheh ◽  
Guillermo Moscatelli ◽  
Samanta Moroni ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Pediatric Patients ◽  
Gene Promoter ◽  
Barr Virus ◽  
Bzlf1 Gene ◽  
Epstein Barr ◽  
Acute Infectious Mononucleosis

scholarly journals Impaired Epstein-Barr Virus-Specific Neutralizing Antibody Response during Acute Infectious Mononucleosis Is Coincident with Global B-Cell Dysfunction

2015 ◽  
Vol 89 (17) ◽  
pp. 9137-9141 ◽  
Author(s):  
Archana Panikkar ◽  
Corey Smith ◽  
Andrew Hislop ◽  
Nick Tellam ◽  
Vijayendra Dasari ◽  
...  
Keyword(s):  
B Cells ◽  
B Cell ◽  
Infectious Mononucleosis ◽  
Neutralizing Antibodies ◽  
Epstein Barr Virus ◽  
Neutralizing Antibody ◽  
Barr Virus ◽  
Cell Dysfunction ◽  
Epstein Barr ◽  
Acute Infectious Mononucleosis

Here we present evidence for previously unappreciated B-cell immune dysregulation during acute Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM). Longitudinal analyses revealed that patients with acute IM have undetectable EBV-specific neutralizing antibodies and gp350-specific B-cell responses, which were associated with a significant reduction in memory B cells and no evidence of circulating antibody-secreting cells. These observations correlate with dysregulation of tumor necrosis factor family members BAFF and APRIL and increased expression of FAS on circulating B cells.

SH2D1A mutations in Japanese males with severe Epstein-Barr virus–associated illnesses

Blood ◽  
2001 ◽  
Vol 98 (4) ◽  
pp. 1268-1270 ◽  
Author(s):  
Ryo Sumazaki ◽  
Hirokazu Kanegane ◽  
Maki Osaki ◽  
Takashi Fukushima ◽  
Masahiro Tsuchida ◽  
...  
Keyword(s):  
Genetic Analysis ◽  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Genetic Disorder ◽  
Lymphoproliferative Disease ◽  
Barr Virus ◽  
Ebv Infection ◽  
Sporadic Cases ◽  
Epstein Barr ◽  
Acute Infectious Mononucleosis

X-linked lymphoproliferative disease (XLP), a genetic disorder characterized by immunodeficiency to Epstein-Barr virus (EBV) infection, has been linked to mutations in the SH2D1A gene. To search for the occurrence of SH2D1A mutations in Japan, we performed genetic analysis of the SH2D1A gene in 40 males presenting with severe EBV-associated illnesses, including fulminant infectious mononucleosis, EBV-positive lymphoma, and severe chronic active EBV infection. SH2D1A mutations were detected in 10 of these 40 patients. Five of these 10 cases were sporadic. Patients with SH2D1A mutations displayed severe acute infectious mononucleosis with hyperimmunoglobulin M, hypogammaglobulinemia, and B-cell malignant lymphoma. By contrast, chronic active EBV infection was not associated with SH2D1Amutations. XLP survivors exhibited normal levels of circulating EBV-DNA during convalescence, suggesting that SH2D1A protein is not directly responsible for control of EBV replication. Thus, genetic analysis of the SH2D1A gene is particularly useful in the diagnosis of sporadic cases and carriers of XLP.

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