The molecular characterization of fatal infectious mononucleosis

Myra J Wick, Kristine P. Woronzoff-Dashkoff, Ronald C. McGlennen

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

We describe a retrospective study of 4 cases of sporadic fatal infectious mononucleosis (IM), 1 case of fatal IM, and 1 case of sporadic severe IM. Patients were 26 months to 17 years old; 3 were male. Five died of complications of IM. All 5 of these patients had the Epstein-Barr virus (EBV) present in examined tissue specimens; EBV was monoclonal in 3 patients and biclonal in 1. EBV clonality studies were not performed in the remaining patient. All 5 patients also had monoclonal gene rearrangements. The sixth patient survived despite a life-threatening clinical course; EBV was oligoclonal, and gene rearrangements were not detected. EBV clonality and gene rearrangement studies may be useful for predicting which patients with clinically aggressive IM are at highest risk for fatal outcome. I Patients in whom IM has a fatal outcome are more likely to have monoclonal or biclonal EBV and immunoglobulin heavy chain or T-cell receptor gene rearrangements. In contrast, patients with nonfatal IM may lack monoclonal EBV and monoclonal rearrangements of the aforementioned genes. The reasons EBV induces a monoclonal proliferation only in some patients remain to be elucidated.

Original languageEnglish (US)
Pages (from-to)582-588
Number of pages7
JournalAmerican Journal of Clinical Pathology
Volume117
Issue number4
DOIs
StatePublished - 2002
Externally publishedYes

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Infectious Mononucleosis
Human Herpesvirus 4
Gene Rearrangement
Fatal Outcome
T-Lymphocyte Gene Rearrangement
T-Cell Receptor Genes
Immunoglobulin Heavy Chains
Retrospective Studies

Keywords

  • Epstein-Barr virus
  • Fatal infectious mononucleosis
  • Gene rearrangements
  • Polymerase chain reaction
  • Southern blot analysis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

The molecular characterization of fatal infectious mononucleosis. / Wick, Myra J; Woronzoff-Dashkoff, Kristine P.; McGlennen, Ronald C.

In: American Journal of Clinical Pathology, Vol. 117, No. 4, 2002, p. 582-588.

Research output: Contribution to journalArticle

Wick, Myra J ; Woronzoff-Dashkoff, Kristine P. ; McGlennen, Ronald C. / The molecular characterization of fatal infectious mononucleosis. In: American Journal of Clinical Pathology. 2002 ; Vol. 117, No. 4. pp. 582-588.
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