Hepatic dysfunction in infectious mononucleosis; with review of the literature.

Abstract

Abstract A series of forty cases of typical infectious mononucleosis has been studied in which twenty-one (55 per cent) of the patients showed moderate to severe hepatic functional involvement or hepatitis as evidenced by a battery of liver function tests. A number of additional patients in the group exhibited milder hepatic involvement on the basis of one or two positive tests. It has not been found feasible to differentiate the type of liver involvement in these patients with infectious mononucleosis and hepatic dysfunction from that in cases of acute epidemic or sporadic hepatitis. One must rely on the clinical picture, especially the presence of pharyngitis, the type of lymphocytic reaction, and the titer of the heterophile antibodies. The character of the liver function disturbances in these patients points to the presence of both hepato-cellular and cholangiolar liver injury. This evidence together with the histologic findings reported in the literature tends to refute the theory that jaundice in infectious mononucleosis is due to an extrahepatic obstruction of the common bile duct by enlarged lymph nodes. The literature on the subject of hepatic involvement in infectious mononucleosis is reviewed.