Treatment of Infectious Mononucleosis

Schumacher, Harold R.; Jacobson, W.; Bemiller, Carl R.

doi:10.7326/0003-4819-58-2-217

Cited by 26 publications

(12 citation statements)

References 35 publications

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“…Negative observations in our 6 cases are buttressed by a previously negative search for T R S in other huffy coat samples (20). Furthermore, an extensive report on the ultrastructure of 8000 lymphocyte sections from 40 patients with infectious mononucleosis did not describe T R S (21).…”

Section: Clinical Specificity and Significance Of Trssupporting

confidence: 39%

Abnormal Structures in Circulating Lymphocytes from Patients with Systemic Lupus Erythematosus and Related Diseases

Grimley

Decker

Michelitch

et al. 1973

Arthritis & Rheumatism

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A prospective electron microscopic study, incorporating blind controls, demonstrated tubuloreticular structures (TRS) in the buffy coat lymphocytes of 32 patients with connective tissue disease. From 1 to 8% of the lymphocyte sections were involved. The abnormal structures consisted of interwoven, electron-dense tubules (220 to 280 A diameter) which were located within the endoplasmic reticulum. Tubuloreticular structures were found in lymphocytes from 20 of 30 patients with systemic lupus erythematosus (SLE), 2 of 4 with discoid lupus erythematosus, 8 of 20 with other connective tissue disease and none of 22 control cases. Clinical evaluation of the patients with SLE disclosed no specific differences between those with TRS-positive or TRS-negative lymphocytes; there were some indications of greater disease activity in the TRS-positive group. The biologic nature of TRS is unknown, but they have been linked to virus infection under both clinical and experimental conditions. systemic lupus erythematosus (SLE) (3-6) and many patients with related diseases of connective tissues (7-9). We now report a significant frequency of morphologically identical structures in the circulating lymphocytes of such patients.T h e tubules in question have been distinguished by their ultrastructural appearance. They are relatively electron-dense and measure in the range of 220 to 280 A in diameter. They are interwoven within membrane-limited compartments which can often be identified as dilatations of the endoplasmic reticulum or perinuclear space. T h e biologic nature of these structures is still unknown, and we have adopted the description tu buloreticular struclures (TRS) also proposed by Dalton (1 0).T h e possibility of finding T R S in circulating cells was suggested by electron microscopic examination of a skin biopsy from a 24-year-old man with SLE with subcutaneous nodules and histologic evidence of chronic vasculitis. Thin

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Section: Clinical Specificity and Significance Of Trssupporting

confidence: 39%

Abnormal Structures in Circulating Lymphocytes from Patients with Systemic Lupus Erythematosus and Related Diseases

Grimley

Decker

Michelitch

et al. 1973

Arthritis & Rheumatism

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“…Treatment of IM with airway obstruction with corticosteroids has been common over the past three decades (Schumacher et al, 1963;Woolf and Diedericks, 1989). Peritonsillar erythema is seen in association with this viral disease, however, whether three days of high dose steroids precipitated the bilateral quinsies seen in this case is speculative.…”

Section: Discussionmentioning

confidence: 99%

Infectious mononucleosis and bilateral peritonsillar abscesses resulting in airway obstruction

Burstin

Marshall

1998

J. Laryngol. Otol.

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Upper airway obstruction is an uncommon but recognized complication of infectious mononucleosis. The management depends upon the degree of airway compromise. In the case described, severe airway obstruction was treated by securing the airway with awake fibre-optic endoscopic intubation and then proceeding to tonsillectomy. Bilateral inferiorly loculated quinsies were encountered unexpectedly and drained. This is the first report of ‘bilateral’ quinsies, associated with infectious mononucleosis and severe airway obstruction. The association, pathogenesis and significance of this finding are also discussed.

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“…[14][15][16] Previous studies that evaluated the efficacy of corticosteroids in IM are primarily based on data collected from inpatient health infirmaries and were done mostly in the 1960s. Schumacher et al 4 found that oral prednisone, 60 mg/d for 5 days, had no effect on symptoms and signs of IM in a double-blind study of 13 patients with an average age of 20 years. However, it is unclear how these symptoms were evaluated.…”

Section: Resultsmentioning

confidence: 99%

“…19 Other studies that evaluated corticosteroids in IM found no risk associated with its short-term use. 4,5,7,8,18 Also, it is interesting to note that for cases involving complications of IM that are believed to be secondary immunopathologic reactions (such as hemolytic anemia, encephalitis, and myocarditis), the administration of corticosteroids is recommended. 20 Three patients from the placebo group were hospitalized, and only 1 patient from the dexamethasone group was hospitalized.…”

Section: Resultsmentioning

confidence: 99%

“…2 Corticosteroids have been shown to reduce the upper airway obstruction caused by IM, but their efficacy for the treatment of the pain associated with the pharyngitis is unclear. [4][5][6][7][8] To further evaluate the efficacy of corticosteroids for pain relief in acute exu-dative pharyngitis associated with IM, we conducted a randomized, double-blind, placebo-controlled, pediatric emergency department (ED)-based clinical trial. Our hypothesis was that patients treated with a single oral dose of dexamethasone would have better relief of sore throat compared with the placebo group.…”

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confidence: 99%

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Dexamethasone for the Treatment of Sore Throat in Children With Suspected Infectious Mononucleosis

Roy

Bailey

Amre³

et al. 2004

Arch Pediatr Adolesc Med

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Treatment of Infectious Mononucleosis

Cited by 26 publications

References 35 publications

Abnormal Structures in Circulating Lymphocytes from Patients with Systemic Lupus Erythematosus and Related Diseases

Abnormal Structures in Circulating Lymphocytes from Patients with Systemic Lupus Erythematosus and Related Diseases

Infectious mononucleosis and bilateral peritonsillar abscesses resulting in airway obstruction

Dexamethasone for the Treatment of Sore Throat in Children With Suspected Infectious Mononucleosis

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