Transient hypertriglyceridemia: a common finding during Epstein-Barr virus-induced infectious mononucleosis

Abstract

Background Hypertriglyceridemia can occur in lymphoproliferative disorders. Infectious mononucleosis is a self-limiting, benign lymphoproliferative disorder. This study aimed to investigate the serum triglyceride concentrations and their change over time in patients with infectious mononucleosis. Methods We evaluated an adult patient with severe hypertriglyceridemia (>1000 mg/dL) during infectious mononucleosis and reviewed the records of 360 patients admitted to our hospital because of infectious mononucleosis (median age, 19 years; range, 15-87 years; 51.4% male). We compared the serum triglyceride concentrations with those of a control sample from the general population (n=75). A second triglyceride measurement, obtained during convalescence (median of 30 days after the initial determination), was available for 160 patients. Results The triglyceride concentrations in the acute phase (median: 156 mg/dL) were significantly higher than those of the controls (median, 76 mg/dL; P<0.001). A total of 194 (53.9%) patients presented with hypertriglyceridemia (>150 mg/dL), which was more common in the patients older than 30 years than in the younger patients (78.6% vs. 50.6%; P<0.001). A significant correlation (P<0.005) was observed between the triglyceride levels and white blood cell counts, total cholesterol levels, and liver damage markers. The triglyceride concentrations decreased during convalescence (P<0.001) and were lower than the initial measurement in 83.7% of the cases. Conversely, the total cholesterol concentrations during the acute phase were lower than those of the controls and increased during convalescence (P<0.001). Conclusions Patients with severe infectious mononucleosis frequently show mild, transient hypertriglyceridemia. Further studies are needed to elucidate the mechanisms underlying this finding.

Risk factors for persistent fever in children with infectious mononucleosis

“…Furthermore, Emilio‐Manuel et al found that lipid metabolism patterns in patients with acute EBV infection were similar to those observed in patients with malignant lymphoproliferative diseases, such as lymphoid leukemia (acute and chronic) and non‐Hodgkin lymphoma. They also revealed that EBV infection leading to abnormal lipid metabolism was associated with neoplastic disease development 21 . Hulse et al reported that EBV infection increased triglyceride levels, which may be associated with the ectopic expression of fatty acid synthase and fatty acid synthesis triggered by EBV and latent membrane protein 1‐mediated B‐cell transformation 22 .…”

“…They also revealed that EBV infection leading to abnormal lipid metabolism was associated with neoplastic disease development. 21 Hulse et al reported that EBV infection increased triglyceride levels, which may be associated with the ectopic expression of fatty acid synthase and fatty acid synthesis triggered by EBV and latent membrane protein 1-mediated B-cell transformation. 22 Epstein-Barr virus infection leads to an increase in blood triglyceride levels, which is considered to be strongly associated with systemic immune inflammation in addition to being associated directly with liver function impairment.…”

Hematological abnormalities beyond lymphocytosis during infectious mononucleosis: Epstein-Barr virus-induced thrombocytopenia

“…We reviewed the clinical records of adult patients (aged 15 years and older) with infectious mononucleosis who were admitted to the University Hospital of Santiago de Compostela (Spain) between 1995 and 2018, as reported elsewhere. 18,19 The hospital is the reference center for an area including approximately 400,000 inhabitants. The main reasons for hospital admission were severe signs of a systemic inflammatory response, difficulty with oral intake, and complications.…”

Documento de consenso para la determinación e informe del perfil lipídico en laboratorios clínicos españoles

“…Tabla 1A 20,21 ). f) Esperar un mínimo de 2-4 semanas tras un proceso inflamatorio agudo, pues puede provocar descenso del c-T, del del colesterol asociado a lipoproteínas de alta densidad (c-HDL) y un incremento de triglicéridos (TG) [22][23][24][25] .…”