title: Nonsteroidal Anti-Inflammatory Drugs Quickly Resolve Symptoms Associated with EBV-Induced Infectious Mononucleosis in Patients with Atopic Predispositions.
abstract: BACKGROUND
  Infectious mononucleosis is a clinical syndrome most commonly associated with primary Epstein-Barr virus (EBV) infection. In adults, the symptoms can often be severe and prolonged, sometimes causing serious complications. Analgesic or antipyretic drugs are normally used to relieve the symptoms. However, there is no causal treatment for the disease.
  
  
  METHODS
  Two cases of adult patients with atopic predispositions developed nocturnal fever, general fatigue, pharyngitis and lymphadenopathy after an exacerbation of atopic symptoms or those of allergic rhinitis. Due to the positive results for EBV viral-capsid antigen (VCA) IgM and negative results for EBV nuclear antigen (EBNA) IgG, diagnoses of infectious mononucleosis induced by EBV were made in both cases. Although oral antibiotics or acetaminophen alone did not improve the deteriorating symptoms, including fever, headache and general fatigue, nonsteroidal anti-inflammatory drugs (NSAIDs), such as tiaramide or loxoprofen, completely improved the symptoms quickly after the initiation.
  
  
  CONCLUSIONS
  In these cases, given the atopic predispositions of the patients, an enhanced immunological response was likely to be mainly responsible for the pathogenesis of the symptoms. In such cases, NSAIDs, that are known to reduce the activity of EBV, may dramatically improve the deteriorating symptoms quickly after the initiation. In the present cases, the immunosuppressive property of these drugs was considered to suppress the activity of lymphocytes and thus provide the rapid and persistent remission of the disease.
authors.affiliation: Department of Physiology I, Tohoku University Graduate School of Medicin, Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Itsuro
authors.initials: I
authors.lastname: Kazama
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tohoku University, Graduate School of Medicine, Sendai, Japan.
authors.forename: Chieko
authors.initials: C
authors.lastname: Miura
authors.affiliation: Department of Internal Medicine, Iwakiri Hospital, Miyagino-ku, Sendai, Miyagi, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D052160:Benzothiazoles / Q000627:therapeutic use; D003876:Dermatitis, Atopic / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000821:virology; D004854:Herpesvirus 4, Human; D006801:Humans; D007244:Infectious Mononucleosis / Q000188:drug therapy*; D008206:Lymphatic Diseases / Q000188:drug therapy / Q000821:virology; D008297:Male; D010612:Pharyngitis / Q000188:drug therapy / Q000821:virology; D010666:Phenylpropionates / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use; D065631:Rhinitis, Allergic / Q000150:complications / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052160:Benzothiazoles; D010666:Phenylpropionates; D010879:Piperazines; C040656:loxoprofen; C003468:tiaramide