Familial Chronic Mononucleosis

doi:10.1059/0003-4819-97-6-821

Familial Chronic Mononucleosis

Farmington and Newington, Connecticut; and Worcester, Massachusetts

Abstract

A syndrome of chronic mononucleosis occurred in two members of a family. Symptoms were chronic malaise and fatigue; recurrent upper respiratory tract infections; and mild, variable immune abnormalities. Intermittently positive heterophil titers were present for more than 2 years after acute infectious mononucleosis. Epstein-Barr-virus-specific antibodies were persistently abnormal. In the proband, the R component of the early antigen complex was present for 3 years and she never developed normal antibodies to Epstein-Barr nuclear antigen. Her brother had low to absent Epstein-Barr nuclear antigen titers, and antibodies to both the R and D component of the early antigen complex. Primary and acquired immunodeficiency states can show abnormal Epstein-Barr-virus-specific serologic findings that may reflect an attempt by the host to limit virus spread in the presence of deficient immune responses. This action may result in alterations of the Epstein-Barr virus-latent state, and lead to a chronic active infection and a syndrome of chronic mononucleosis.

Article and Author Information

▸From the Departments of Pediatrics and Medicine, the University of Connecticut Health Center, Farmington, Connecticut; the Veterans Administration Medical Center, Newington, Connecticut; and the Department of Pathology, the University of Massachusetts Medical Center, Worcester, Massachusetts.
Grant support: in part by grant HD 12050 from the National Institute of Child Health and Human Development; CA 23561 and CA 22202 from the National Cancer Institute; and the Medical Research Service of the Veterans Administration.
▸Requests for reprints should be addressed to Mark Ballow, M.D.; University of Connecticut Health Center, Department of Pediatrics; Farmington, CT 06032.