Infectious Mononucleosis in a Patient with Hodgkin’s Disease

Abstract

The case is presented of a patient, treated for Hodgkin’s disease, who contracted infectious mononucleosis more than 3 years later. While Epstein-Barr virus has been considered a possible etiologic factor in Hodgkin’s disease, the sequence of events reported in this case has to be interpreted as evidence against a causal relationship between the virus and Hodgkin’s disease in this patient.

Infectious Mononucleosis in Hodgkin’s Disease

“…This report, describing the development of IM in a patient receiving treatment for HD, is in contrast to that previously reported, where IM followed its curative treatment [7], Although unexpected false-positive persisting IM heterophil antibody [1] and transient Monospot test [16] have been singularly reported in HD, we feel that the typical peripheral blood picture and pattern of IM heterophil and EBV antibody tilres, establish beyond doubt, the diagnosis of IM in our patient, whose clinical presentation had been uncharacteristic. The sequence of events in this case thus supports the conclusion of L angenhuysen [7] and in addi tion, must strongly question the suggested causal relationship between EBV and HD.…”

“…The sequence of events in this case thus supports the conclusion of L angenhuysen [7] and in addi tion, must strongly question the suggested causal relationship between EBV and HD.…”

“…Serious doubts have therefore been cast on any specific or causal role for EBV in HD. This view gains support from the few descriptions of the simultaneous presentation of the two disorders [4,10], and even more, from the recent and previously unreported development of IM in a pa tient who, 3 years previously had undergone curative treatment for HD [7]. The purpose of this brief communication is to report the occurrence of IM in a further patient with established HD.…”

Hodgkin's disease in patients with previous infectious mononucleosis

“…Moreover, EBV-antibodies are not found in all patients with HD, and some studies have shown similar proportion of past EBV infection in patients with H D as compared to appropriate controls (Goldman and Aisenberg, 1970;Henle and Henle, 1973;Langenhuysen et al, 1974;Hesse et al, 1977;Lange et al, 1978). A few cases of IM in patients with H D have also been reported (Kenis et at., 1958;Langenhuysen, 1976;Davidson and Lessels, 1977). However, H D may be a heterogenous disease, and if EBV plays a role in the aetiology of the disease, it can obviously be of importance only in a proportion of the patients with HD.…”

Hodgkin's disease following infectious mononucleosis

“…Although in many cases of HD serum titers against EBV are somewhat increased [4,5], some cases of HD show no antibody evidence of EBV infection. Serious doubts as to any specific role for EBV in HD come from cases with established HD in which IM occurred during the course of the disease [6,7]. The purpose of this communication is to show by DNA analysis of the tumor cells-searching for EBV genomes--that, although HI) developed shortly alter IM and antibody response to EBV was compatible with the convalescent phase of IM, EB-viral infection most likely may not be directly oncogenic but rather may contribute to an immunologic state which in turn predisposes to malignancy.…”