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Chronic mononucleosis syndrome
Abstract:
We present data on 14 patients with chronic symptoms of disabling fatigue in association with serologic evidence of active Epstein-Barr virus (EBV) infection. Two thirds were women, and the average age at onset was 29.6 years. Forty-three percent were known to have had previous infectious mononucleosis, but the usual criteria for that diagnosis were not helpful with the present syndrome. Eighty-six percent had serologic evidence of cytomegalovirus (CMV) infection. Profound immunodeficiency was not present, but 71% had partial hypogammaglobulinemia, and minor abnormalities of T cell subsets were noted in six of seven patients studied. Fifty-seven percent achieved temporary serologic and symptomatic remission after an average duration of 33 months. Only one patient has a sustained remission. Comparison is made with other reported chronic, recurrent, and persistent EBV syndromes, and tentative diagnostic criteria for chronic mononucleosis syndrome are presented. Recently available EBV serologic techniques allow for identification of patients who have reactivated EBV infection, and this reactivation may be related to symptoms.
Insights
Chronic Epstein-Barr virus (EBV) infection can cause disabling fatigue. New serologic techniques help identify EBV reactivation linked to these chronic symptoms.
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.