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Infectious mononucleosis – should we routinely assess liver function in acute presentation and follow up?

Published online by Cambridge University Press:  25 April 2022

L Simpson Open the ORCID record for L Simpson [Opens in a new window] ,
E Sutherland ,
D Wilkinson ,
R Saman  and
O Edafe
L Simpson*
Affiliation:
Department of ENT, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
E Sutherland
Affiliation:
Department of ENT, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
D Wilkinson
Affiliation:
General Surgery, Rotherham General Hospital, UK
R Saman
Affiliation:
Infectious Diseases, Leeds Teaching Hospitals NHS Trust, UK
O Edafe
Affiliation:
Department of Oncology and Metabolism, University of Sheffield, UK
*
Author for correspondence: Miss Laura Simpson, Department of ENT, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK E-mail: Laura.Simpson11@nhs.net
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Abstract

Objective

Infectious mononucleosis is a relatively common acute presentation to the ENT department. There is an expected derangement in the liver function test results in most patients. There is no guidance regarding follow up, and practice varies. This study aimed to evaluate the utility of liver function tests and abdominal ultrasound in infectious mononucleosis.

Methods

This was a retrospective study of all adult patients admitted under ENT with infectious mononucleosis over a five-year period.

Results

A total of 153 patients were included; 80 per cent had abnormal liver function test results at presentation. Around 50 per cent had at least one liver function test assessment following discharge. Median (interquartile range) time to resolution of liver function test results was 32 days (20–50 days); maximum time was 10 months. Six patients had in-patient abdominal ultrasound: all showed a normal liver and biliary tree. No patient developed any liver disease sequelae.

Conclusion

The findings suggest that serial assessment of liver function is not required in immunocompetent adults with subclinical derangement in liver function.

Keywords

Infectious MononucleosisEpstein-Barr Virus InfectionsAcute Liver FailureChronic Hepatitis
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 3 , March 2023 , pp. 319 - 322
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Miss L Simpson takes responsibility for the integrity of the content of the paper

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