European Journal of Pediatrics

, Volume 167, Issue 12, pp 1449–1452 | Cite as

Splenic infarction in a patient hereditary spherocytosis, protein C deficiency and acute infectious mononucleosis

  • Christian Breuer
  • Gisela Janssen
  • Hans-Jürgen Laws
  • Jörg Schaper
  • Ertan Mayatepek
  • Horst Schroten
  • Tobias Tenenbaum
Original Paper


Splenic infarction is a common cause of left upper quadrant pain and must be suspected in patients with hematologic or thromboembolic conditions and signs of localized or systemic inflammation. Although several mechanisms have been proposed for splenic infarction in patients with various hematologic disorders, hereditary spherocytosis (HS) is usually not associated with an increased risk for thromboembolic events. We report a 13-year-old male with HS who was referred to our hospital with a 4-day history of fever and left upper quadrant pain. Ultrasound scans and magnetic resonance imaging showed lesions suggestive of splenic infarction. Initially, antibiotic treatment was started because secondary infection was suspected. However, 1 week after admission the patient developed typical clinical signs of acute infectious mononucleosis. Further laboratory work up confirmed the diagnosis of acute Epstein–Barr virus infection and additionally revealed protein C deficiency. This association has not been reported previously and may have contributed to the development of splenic infarction. Since infectious mononucleosis is a common cause for clinical consultations in adolescence, physicians caring for children with hematologic disorders should be particularly aware of those possible complications.


Epstein-Barr virus Hereditary spherocytosis Infectious mononucleosis Protein C deficiency Splenic infarction 


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Christian Breuer
    • 1
  • Gisela Janssen
    • 2
  • Hans-Jürgen Laws
    • 2
  • Jörg Schaper
    • 3
  • Ertan Mayatepek
    • 1
  • Horst Schroten
    • 1
    • 4
  • Tobias Tenenbaum
    • 1
    • 4
  1. 1.Pediatric Infectious Diseases, Department of General Pediatrics, University Children’s HospitalHeinrich-Heine-UniversityDusseldorfGermany
  2. 2.Department for Pediatric Oncology, Hematology and Immunology, University Children’s Hospital Heinrich-Heine-UniversityDusseldorfGermany
  3. 3.Department for Pediatric Radiology, University Children’s Hospital Heinrich-Heine-UniversityDusseldorfGermany
  4. 4.Pediatric Infectious Diseases, Department of Pediatrics, University Hospital Mannheim University of HeidelbergMannheimGermany

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