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Serial serum enzyme studies in infectious mononucleosis
Scandinavian Journal of Infectious Diseases
|January 1, 1976
Summary
Infectious mononucleosis patients showed elevated white blood cells and liver enzymes early on. Elevated lactic dehydrogenase (LDH) levels persisted longer, indicating prolonged lymphoid cell activity.
Area of Science:
- Hematology
- Clinical Biochemistry
- Virology
Background:
- Infectious mononucleosis (IM) is a common viral illness.
- Elevated liver enzymes and altered blood cell counts are typical IM findings.
- The duration and cause of these alterations require further investigation.
Purpose of the Study:
- To investigate serial changes in white blood cells, serum glutamic oxaloacetic transaminase (GOT), and lactic dehydrogenase (LDH) isoenzymes in patients with infectious mononucleosis.
- To differentiate between liver involvement and lymphoid cell proliferation as causes of elevated LDH.
Main Methods:
- Serial blood samples were collected from 36 patients with seropositive infectious mononucleosis.
- White blood cell counts, GOT levels, and LDH isoenzyme profiles (including LDH V) were analyzed.
- Patients were monitored over several weeks to months post-onset.
Main Results:
- 90% of patients had elevated mononuclear cells, 70% elevated GOT, and 100% elevated LDH at disease onset.
- Elevated LDH was primarily due to isoenzymes I, II, and III, with only 35% showing increased LDH V (liver fraction).
- Mononuclear cells normalized by 5 weeks, GOT by 10 weeks, but elevated LDH (isoenzymes I, II, III) persisted in 50% of patients at 4 months.
Conclusions:
- Liver involvement in infectious mononucleosis appears to be mild and transient.
- Prolonged elevation of LDH, particularly isoenzymes I, II, and III, suggests sustained lymphoid cell proliferation.
- These findings help differentiate the duration and source of enzyme elevations in IM.