TITLE:
A Case of Infectious Mononucleosis Complicated by Severe Thrombocytopenia and Hyperuricemia
AUTHORS:
Vaia Papageorgiou, Georgios Kaltsounis, Konstantinos Loukidis, Anna Kioumi
KEYWORDS:
Infectious Mononucleosis, Thrombocytopenia, Hyperuricemia, Case Report
JOURNAL NAME:
Open Journal of Blood Diseases,
Vol.6 No.1,
March
18,
2016
ABSTRACT: Infectious mononucleosis (IM) by Epstein-Barr virus is usually a benign, self-limiting disease. Mild
to moderate immune thrombocytopenia in the setting of IM is very common and appears in approximately
half of these patients, however it rarely presents in severe form and troublesome
haemorrhage is even rarer. Rapid spontaneous resolution is possible, with the role of steroids being
controversial. Furthermore, elevation of the levels of uric acid because of immune thrombocytopenia
is observed in high frequency; however this finding is usually not mentioned. It is attributed
to a transient increase in purine turnover, it appears more often in men (with its peak
within the first 2 weeks of IM) and it is treated with intravenous fluids and bicarbonates. The
present case report describes the case of a young female patient who develops severe thrombocytopenia
and intense hyperuricemia following an Epstein-Barr infection. No severe bleeding appeared,
levels of uric acid normalised within the first two weeks of treatment and platelet levels
rise back to normal within a month under corticosteroid therapy.