Chronic mononucleosis syndrome.

Area of Science:

• Immunology
• Virology
• Infectious Diseases

Background:

• Chronic fatigue is a debilitating symptom impacting many individuals.
• Epstein-Barr virus (EBV) reactivation is increasingly recognized as a potential cause of persistent symptoms.
• Distinguishing EBV-related chronic illness from other conditions can be challenging.

Purpose of the Study:

• To investigate the clinical and serologic features of patients with chronic fatigue and active Epstein-Barr virus (EBV) infection.
• To explore potential immunologic abnormalities associated with this syndrome.
• To propose tentative diagnostic criteria for chronic mononucleosis syndrome.

Main Methods:

• Analysis of clinical data from 14 patients presenting with chronic fatigue and serologic evidence of active EBV infection.
• Serologic testing for Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections.
• Assessment of immunologic parameters including immunoglobulin levels and T cell subsets.

Main Results:

• The study included 14 patients (two-thirds women, average age at onset 29.6 years) with chronic fatigue and active EBV infection.
• Eighty-six percent showed serologic evidence of cytomegalovirus (CMV) infection; 71% had partial hypogammaglobulinemia.
• Fifty-seven percent experienced temporary remission, but only one patient achieved sustained remission.

Conclusions:

• Reactivated Epstein-Barr virus (EBV) infection may be linked to chronic disabling fatigue and associated symptoms.
• Partial hypogammaglobulinemia and minor T cell subset abnormalities are observed in some patients.
• Tentative diagnostic criteria for chronic mononucleosis syndrome are proposed based on EBV serologic findings.