Markin R S, Linder J, Zuerlein K, Mroczek E, Grierson H L, Brichacek B, Purtilo D T
Department of Pathology, University of Nebraska Medical Center, Omaha 68105.
Gastroenterology. 1987 Dec;93(6):1210-7. doi: 10.1016/0016-5085(87)90246-0.
A detailed clinicopathologic analysis of 30 patients with sporadic fatal infectious mononucleosis and 31 males with fatal infectious mononucleosis and the X-linked lymphoproliferative syndrome was performed to determine the extent of hepatic dysfunction in these cases. At death, the median age of patients with sporadic infectious mononucleosis was 10.7 yr vs. 2.4 yr for X-linked lymphoproliferative syndrome. The median survival time was 8 wk for sporadic infectious mononucleosis and only 4 wk for X-linked lymphoproliferative syndrome. The male to female ratio was 3:2 in sporadic infectious mononucleosis; all patients with X-linked lymphoproliferative syndrome were males. Fever, sore throat, lymphadenopathy, hepatomegaly, and splenomegaly were prominent findings. Hepatic dysfunction was uniformly present and caused death in 13 of 30 sporadic infectious mononucleosis cases and 18 of 31 X-linked lymphoproliferative syndrome cases. Diagnosis of infectious mononucleosis was confirmed by heterophile antibody titers or Monospot, Epstein-Barr virus antibody studies, viral culture, molecular hybridization studies, clinical and histologic findings, and pedigree analysis.
对30例散发性致命传染性单核细胞增多症患者以及31例患有致命传染性单核细胞增多症和X连锁淋巴增殖综合征的男性患者进行了详细的临床病理分析，以确定这些病例中肝功能障碍的程度。死亡时，散发性传染性单核细胞增多症患者的中位年龄为10.7岁，而X连锁淋巴增殖综合征患者为2.4岁。散发性传染性单核细胞增多症的中位生存时间为8周，而X连锁淋巴增殖综合征仅为4周。散发性传染性单核细胞增多症的男女比例为3:2；所有X连锁淋巴增殖综合征患者均为男性。发热、咽痛、淋巴结病、肝肿大和脾肿大是突出表现。肝功能障碍普遍存在，在30例散发性传染性单核细胞增多症病例中有13例以及31例X连锁淋巴增殖综合征病例中有18例因肝功能障碍死亡。传染性单核细胞增多症的诊断通过嗜异性抗体滴度或单核细胞增多症斑点试验、爱泼斯坦-巴尔病毒抗体研究、病毒培养、分子杂交研究、临床和组织学发现以及家系分析得以证实。
