Renal enlargement associated with infectious mononucleosis

Area of Science:

• Pediatric Infectious Diseases
• Viral Hepatitis
• Nephrology

Background:

• Infectious mononucleosis (I.M.), typically caused by Epstein-Barr virus (EBV), is a common viral illness.
• While generally self-limiting, severe cases can present with prolonged symptoms and complications.
• Hepatic involvement is a known, though usually transient, manifestation of I.M.

Observation:

• A pediatric patient presented with severe infectious mononucleosis, characterized by prolonged fever and hepatitis lasting eight weeks.
• Serological tests confirmed the diagnosis of I.M. through heterophile antibody and ox cell hemolysin development.
• Intravenous urography revealed bilateral renal enlargement during the acute phase of the illness.

Findings:

• The renal enlargement was observed despite the absence of significant clinical or laboratory indicators of renal disease.
• Fifteen months post-discharge, the patient exhibited normal clinical and laboratory findings.
• Follow-up imaging demonstrated a marked decrease in kidney size, suggesting the renal enlargement was a transient phenomenon.

Implications:

• This case highlights a rare, temporary renal manifestation associated with severe infectious mononucleosis in children.
• The findings suggest that significant renal enlargement can occur in I.M. without indicative renal pathology.
• Further investigation may be warranted to understand the mechanisms behind EBV-induced renal changes and their clinical significance.