In this report we present a rare case of esophageal rupture that has never been described in the. However, this mono complication does not always result from mononucleosis. However, from 1966 to 1976, 195 cases of fatal infectious mononucleosis were reported the u. While hepatitis linked to mono is generally mild, it can pose health risks and in some cases can be quite serious. Discusses possible causes other than mono for elevated liver enzymes. Epsteinbarr virus and its association with disease kobenhavns. The findings were compared with a similar group of 30 patients with infectious hepatitis. Acute epstein barr virus hepatitis without mononucleosis. Acetaminophen tylenol must also be metabolized by your liver and should be avoided. Mono is usually a mild illness that goes away without treatment after several weeks. However, randomized studies have not been performed for all of these treatments of infectious mononucleosis hepatitis.
Hepatitis a and hepatitis b can be prevented by vaccination. Sep 02, 2016 elevated liver enzymes accompanied by infectious mononucleosis syndrome are widely seen in primary epsteinbarr virus infection while acute symptomatic hepatitis without typical presentations of ebv is extremely rare. Characteristics of epsteinbarr virus hepatitis among patients with. Over 50% of college studentshave antibodies to the eb virus, implying prior infection. The essential histologic features of infectious mononucleosis were the presence in the hepatic sinusoids and portal tracts of chronic inflammatory cells resembling small. Mononucleosis mono is an infectious disease caused most often by the epsteinbarr virus ebv. However, the assumption that alcoholic liver disease always progresses linearly from alcoholic fatty liver, to alcoholic hepatitis and ultimately to cirrhosis is. Cases of hepatitis in immunodeficient persons who lack hepatitis a and b surface markers may be. Acute hepatitis due to infectious mononucleosis in a 21. In the following report, we present a patient with acute isolated hepatitis due to laboratory confirmed epsteinbarr virus. Hepatitis in infectious mononucleosis annals of internal. She brought along an ultrasound scan of her liver and the accompanying report, which stated there were fatty changes in her liver, consistent with mild to moderate fatty liver. The majority of patients with infectious mononucleosis recovers without apparent sequelae. The demographics, clinical features and outcome of ebv hepatitis a.
People with mono hepatitis do tend to be sicker, especially if they experience vomiting and dehydration. The most common types of viral hepatitis are a, b, and c. She did not have a history of consumption of drugs and alcohol or travel to areas with high endemicity for any infectious diseases during the last 6 months. Feb 01, 2003 cytomegalovirus cmv is a prevalent pathogen, with 40 to 100 percent of the general population showing prior exposure by serology. It is usually passed to susceptible people through intimate contact with infected saliva. However, these viruses can also spread through blood and semen during sexual contact, blood transfusions, and organ transplantations. In our cases, both patients soon recovered with only conservative treatment. Acute infectious mononucleosis im is a common illness that presents to urgent care facilities. Infectious mononucleosis is a clinical syndrome most commonly associated with primary epsteinbarr virus infection.
Alcoholic hepatitis symptoms and causes mayo clinic. They all affect the liver and have similar symptoms, but transmission and treatments differ. Symptoms can vary from sore throat, enlarged lymph glands, lethargy and weight loss to more serious clinical manifestations such as myocarditis or hepatitis. However, the relationship between drinking and alcoholic hepatitis is complex. Sore throat, perhaps misdiagnosed as strep throat, that doesnt get better after treatment with antibiotics. Twentytwo patients with infectious mononucleosis were studied by liver biopsy and paper electrophoresis of the serum proteins. This occurs in only one or two people with mono per 1,000, usually in the first three weeks of illness. Doctor answers on symptoms, diagnosis, treatment, and more. Ebv is the most common cause of infectious mononucleosis, but other viruses can cause this disease. Infectious mononucleosis in the past has signified to many physicians a mild infectious disease primarily affecting the nasopharynx and distinguishable from ordinary infections of the upper respiratory passages by striking enlargement of the lymph nodes, the appearance in the blood of large numbers of lymphocytes of characteristic bizarre type, and the development during convalescence of. He had no history of smoking or alcohol, and no family history of liver disease. Ebv is usually in the body for 3050 days before the onset of symptoms.
Mono virus which is in the saliva of a person and can get transferred to the other person through exchange of saliva. Nov 03, 2017 alcoholic hepatitis is a diseased, inflammatory condition of the liver caused by heavy alcohol consumption over an extended period of time. Hepatic involvement in infectious mononucleosis springerlink. He had not drunk unpasteurized milk or consumed alcohol. Infectious mononucleosis, hepatitis, splenic rupture, airway compromise. Mononucleosis is sometimes called the kissing disease, but kissing isnt the only way you can get it. Many people who get mono do not even know they have it. The pathogenesis of autoimmune diseases includes a combination of genetic factors and environmental exposures including infectious agents. The virus infects a certain type of white blood cell called b lymphocytes. Hepatitis owing to primary ebv infection is usually mild and. Epsteinbarr virus infections are associated with hepatocellular hepatitis. Infectious mononucleosis complicated by acute hepatitis and.
Infectious mononucleosis due to epsteinbarr virus ebv infection sometimes causes acute hepatitis, which is usually selflimiting with mildly elevated transaminases, but rarely with jaundice. Malnutrition is common in people with alcoholic hepatitis. Acute hepatitis due to infectious mononucleosis in a 21year. Infectious mononucleosis mono is an epsteinbarr virus ebv infection of the lymphatic system. It could go undetected clinically and it resolves spontaneously. May 07, 2017 mono is a virus, infectious mononucleosis is sometimes called mono or the kissing disease.
The suggestion is made that though mononucleosis hepatitis is milder than infectious hepatitis, the pathologic changes occurring in the liver in these diseases may be the same and differ only in extent depending solely upon the. The presenting symptoms of acute im can range from the obvious, such as persistent exudative tonsillitis and marked cervical lymphadenopathy, to the more vague symptoms of fatigue and malaise. Infectious mononucleosis, or glandular fever, is a viral illness which commonly affects young adults. Fatal infectious mononucleosis was recognized in only 20 cases before 1970 2. It is estimated to be 10% in young adults and 30% in the elderly where it presents itself as an anicteric viral hepatitis. Nov 27, 2009 there is a case report of the successful use of ganciclovir in two immunocompetent patients with severe infectious mononucleosis hepatitis. Epsteinbarr virus reactivation the lancet infectious diseases. Monorelated hepatitis is generally mild and does not cause liver damage, except in rare cases. Pdf infectious mononucleosis hepatitis in young adults. Infectious mononucleosis hepatitis in young adults. Alcoholic hepatitis is a type of hepatitis caused by drinking excessive amounts of alcohol over many years. This is because it does not usually cause any symptoms, although it can cause sudden jaundice and liver failure in some people. Alcoholic liver disease is defined by three stages of liver damage following chronic heavy alcohol consumption.
The spectrum of liver disease extends from acute and chronic hepatitis caused primarily by alcohol or viral infection to cirrhosis, liver failure, and liver cancer resulting from viral hepatitis, alcoholic liver disease, or toxins. However, infectious mononucleosis may be associated with several acute complications. I nfectious mononucleosis is a clinical syndrome caused by epsteinbarr virus ebv that is particularly common in adolescents and children. Be kindto your liver and dont drink alcoholic beverages while you are recovering. Epsteinbarr virus ebv, a member of the family of herpes viruses, infects up to 90% of the general population by the age of 20 years, the most common clinical presentation of ebv infection includes the triad of fever, generalized lymphadenopathy and pharyngitis, forming the picture of infectious mononucleosis. Serial liver biopsy studies revealed a lesion indistinguishable from viral hepatitis. A diagnosis of infectious mononucleosis with hepatitis was made. It is caused most often by the epsteinbarr virus ebv, which is in the herpesvirus family of organisms. Rupture of the spleen rupture of the spleen is a rare, but serious complication of mono. The liver in infectious mononucleosis springerlink. Mononucleosis mono is not typically a serious disease, but it may lead to serious complications.
Ebv is rather uncommonly confirmed as an etiologic agent of acute hepatitis in adults. Large studies of infectious mononucleosis are now decades old, but traditionally, the peak incidence of infection has been described in the 15 to 24year age range. Mononucleosis results from the epsteinbarr virus ebv that belongs to the herpes family. Infectious triggers are commonly indicated as being involved in the induction of autoimmune disease, with epsteinbarr virus ebv being implicated in several autoimmune disorders. Is alcoholic hepatitis contagious answers on healthtap. Fulminant epsteinbarr virus infectious mononucleosis in an. Hepatic ascites due to chronic alcoholic hepatitis icd10cm diagnosis code k70. One of the complications of infectious mononucleosis is hepatitis. Acceptable if you had jaundice or hepatitis caused by something other than a viral infection, for example. Mononucleosis fact sheet infectious mononucleosis mono is caused by a virus the epsteinbarr virus ebv that causes mononucleosis is a type of herpes virus. Its commonly caused by a viral infection, but there are other possible causes of hepatitis. Ebv is appealing in the pathogenesis of autoimmune disease, due to its high.
A case of infectious mononucleosis complicated by hepatic involvement is reported. Treatment is usually conservative although there has been significant debate over the role of oral corticosteroids, especially in more. Epsteinbarr virus as a trigger of autoimmune liver diseases. Avoid alcohol many people with infectious mono also have a mild liver inflammation, or hepatitis. Singleserum samples were taken from patients with acute gastroenteritis of different origin, acute viral hepatitis, alcoholic liver disease, and hbsag carriers, and were screened for viral capsid antigen vcaigm, igg, and ebvassociated nuclear antigen ebna antibodies. This includes those who had hepatitis with cytomegalovirus cmv, or epsteinbarr virus ebv, the virus that causes mononucleosis. The condition is common in the uk and many people do not realise they have it. Maree came to see me for help with a fatty liver, excess weight and chronic exhaustion from long term infection with epstein barr virus. Hepatitis your one stop information source about mono. Chronic liver disease continues to be a major health concern in canada.
Pdf infectious mononucleosis im, a benign lymphoproliferative disease. Discusses blood test to study liver function and to find out if the liver is inflamed. The most common sign of alcoholic hepatitis is yellowing of the skin and whites of the eyes jaundice. Acute epstein barr virus hepatitis without mononucleosis syndrome. His family history was unremarkable, and he had no history of liver disease. Alcoholic hepatitis is a diseased, inflammatory condition of the liver caused by heavy alcohol consumption over an extended period of time. Effective treatments for hepatitis c are available but costly. Typical features of infectious mononucleo sis include fever, pharyngitis, adenopathy, malaise, and an atypical lymphocytosis. Typically, these viruses spread most commonly through bodily fluids, especially saliva. Hepatitis refers to an inflammatory condition of the liver.
Most people become infected with ebv at some point in their lives. Some data derived in the united kingdom suggest that infectious mononucleosis im cases may be occurring later in life with increasing severity, requiring hospitalization. Like all herpesviruses, ebv stays within the body once a person is infected. Mild infectious mononucleosis presenting with transient. The viru s is shed in saliva and spreads through direct contact. Hepatitis b is quite communicable, but it takes direct blood to blood contact e. Alcohol must be metabolized by the liver and may be toxic to lever cells. Learn from the experts at webmd how to spot the signs of mono and get the right treatment. Mono also known by its nickname is called kissing disease. Rheumatoidfactorpositive cases were excluded from the study. May 09, 2017 hepatitis refers to an inflammatory condition of the liver. Not all heavy drinkers develop alcoholic hepatitis, and the disease can occur in people who drink only moderately. Mar 20, 2020 hepatitis is a complication that is caused by the epsteinbarr virus, which also causes mononucleosis, commonly referred to as mono. East asia, in particular mongolia, is the region most affected.