[Infections mononucleosis with pleural effusion].
A 24-year-old man was admitted to our hospital for further examination of pleural effusion. On physical examination, he had a temperature of 39 degrees C, the pharynx was painful and liver and spleen were enlarged. The leukocyte count was 5,700/microliters (atypical lymphocyte 6%). The serum LDH, GOT, GPT, ALP and gamma-GTP levels were elevated, and antibodies to Epstein-Barr viral capsid, early, and nuclear antigens were diagnostic of a primary Epstein-Barr virus infection. The CD4/CD8 ratio of peripheral blood lymphocyte was decreased to 0.2. The pleural effusion was exudate, and infiltration of mononuclear cells was noted. The CD4/CD8 ratio of lymphocytes in the effusion also was decreased to 1.1. The result of pleural biopsy showed a perivascular infiltration of mononuclear cells and immunological stain showed that the infiltrated cells were dominantly T-lymphocytes (about 90%). These findings suggested that the pathogenesis of pleural effusion in infectious mononucleosis was a pleulitis due to the infiltration of T-lymphocytes. Pleural effusion is known as a rare complication of infectious mononucleosis.
Takakura
Y
Y
First department of internal medicine, Kyoto Prefectural University of Medicine.
Kobayashi
Y
Y
Takahashi
Y
Y
Chikayama
S
S
Ikeda
M
M
Uoshima
N
N
Kimura
S
S
Tanaka
K
K
Wada
K
K
Ozawa
M
M
Kitazumi
S
S
Kondo
M
M
D000328:Adult; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D010994:Pleura / Q000473:pathology; D010996:Pleural Effusion / Q000209:etiology* / Q000473:pathology; D010998:Pleurisy / Q000150:complications / Q000473:pathology; D013601:T-Lymphocytes / Q000473:pathology