Infectious Mononucleosis and Complications

  • James Linder
  • David T. Purtilo


Infectious mononucleosis (IM) is a febrile illness of older children and young adults caused by the Epstein-Barr virus (EBV). The diagnosis is based on the triad of physical, hematologic and serologic findings. In this chapter we review the discovery of IM, the typical and atypical cases. We emphasize immunologic determination of the outcome of the infection by EBV. Several monographs discuss the historical and clinical aspects of IM (12,39,54).


Aplastic Anemia Infectious Mononucleosis Splenic Rupture Atypical Lymphocyte Bovine Erythrocyte 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Adkins, B.J. and Steele, R.H. Death from massive hepatic necrosis in infectious mononucleosis. N.Z. Med. J., 85:56, 1977.PubMedGoogle Scholar
  2. 2.
    Ainley, N.J. A fatal case of infectious mononucleosis with extensive zonal necrosis of the liver. Ulster. Med J., 18:219, 1949.PubMedGoogle Scholar
  3. 3.
    Aiuti, F., Rocchi, G., D’Amelio, R., Giunta, S., and Fiorilli, M. Lymphoid cells in infectious mononucelosis classified according to T and B cell markers. Int. Archs. Allergy Apl. Immun., 48:353, 1975.CrossRefGoogle Scholar
  4. 4.
    Aung, M.K., Goldberg, M. and Tobin, M.S. Splenic rupture due to infectious mononucleosis. J. Am. Med. Assoc., 240:1752, 1978.CrossRefGoogle Scholar
  5. 5.
    Ballow, M., Seeley, J., Purtilo, D.T., St. Onge, S., Sakamoto, K., and Rickles, F.R. Familial chronic mono-nucleosis. Ann. Int. Med., 97:821, 1982.PubMedGoogle Scholar
  6. 6.
    Bodansky, H.J. Erythema nodosum and infectious mono nucleosis. Brit. Med. J., 2:1263, 1979.PubMedCrossRefGoogle Scholar
  7. 7.
    Bowman, M.S., Marsh, W.L., Schumacher, M.R., Oyen, R. and Reinhart, J. Auto anti-N immunohemolytic anemia in infectious mononucleosis. Am. J. Clin. Path., 62:465, 1974.Google Scholar
  8. 8.
    Burkitt, D.P. A sarcoma involving the jaws in African children. Br. J. Surg., 46:218, 1958.PubMedCrossRefGoogle Scholar
  9. 9.
    Calvo, R., Stein, W., Kochwa, S., and Rosenfield, R.E. Acute hemolytic anemia due to anti-i; Frequent cold agglutinins in infectious mononucleosis. J. Clin. Invest., 44:1033, 1965.Google Scholar
  10. 10.
    Carter, R.L. Platelet levels in infectious mononucleosis. Blood, 25:817, 1965.PubMedGoogle Scholar
  11. 11.
    Carter, R.L. Granulocyte changes in infectious mono nucleosis. J. Clin. Path., 19:279, 1966.PubMedCrossRefGoogle Scholar
  12. 12.
    Carter, R.L. and Penman, H.G. Infectious Mononucleosis, Blackwell, Oxford, 1969.Google Scholar
  13. 13.
    Chang, R.S. Infectious mononucleosis. Hall, Boston, 1980.Google Scholar
  14. 14.
    Contratto, A.W. Infectious mononucleosis. A study of one hundred and ninety six cases. Arch. Intern. Med., 73:449, 1944.CrossRefGoogle Scholar
  15. 15.
    Davidsohn, I. and Lee, C.L. The clinical serology of infectious mononuclesois. In:R.L. Carter and H.G. Penman (eds.) Infectious Mononucleosis. p. 171. Blackwell, Oxford, 1969.Google Scholar
  16. 16.
    Davidson, R.J.L. New slide test for infectious mono nucleosis. J. Clin. Pathol., 20:643, 1967.PubMedCrossRefGoogle Scholar
  17. 17.
    DeNardo, G.L. and Ray, J.P. Hereditary spherocytosis and infectious mononucleosis with acquired hemolytic anemia. Am. J. Clin. Path., 39: 284, 1963.PubMedGoogle Scholar
  18. 18.
    DeWaele, M., Thielemans, C., and VanCamp, B.K.G. Characterization of immunoregulatory T cells in EBV-induced infectious mononucleosis by monoclonal antibodies. N. Engl. J. Med., 304: 460, 1981.CrossRefGoogle Scholar
  19. 19.
    Diehl, V., Henle, G., Henle, W., and Kohn, G. Demonstration of a herpes group virus in cultures of peripheral leukocytes from patients with infectious mononucleosis. J. Virol., 2:663, 1968.PubMedGoogle Scholar
  20. 20.
    Dorfman, R.F. and Warnke, R. Lymphadenopathy simulating the malignant lymphomas. Hum. Pathol., 5: 519, 1974.PubMedCrossRefGoogle Scholar
  21. 21.
    Downey, H. and McKinlay, C.A. Acute lymphadenosis compared with acute lymphatic leukemia. Arch. Int. Med., 32:82, 1923.CrossRefGoogle Scholar
  22. 22.
    Edwards, J.M.B. and McSwiggan, D.A. Studies on the diagnostic value of an immunofluorescence test for EB virus-specific IgM. J. Clin. Path., 27:647, 1974.PubMedCrossRefGoogle Scholar
  23. 23.
    Ellman, L., Carvalho, A., Jacobson, B.M., and Colman, R.W. Platelet autoantibody in a case of infectious mononucleosis presenting as thrombocytopenic purpura. Am. J. Med., 44:723, 1973.CrossRefGoogle Scholar
  24. 24.
    Epstein, M.A., Achong, B.G., and Barr, Y.M. Virus particles in cultured lymphoblasts from Burkitt’s lymphoma. Lancet, i:702, 1964.CrossRefGoogle Scholar
  25. 25.
    Evans, A.S., Niederman, J.C., and McCollum, R.W. Seroepidemiologic studies of infectious mononucleosis with EB virus. N. Engl. J. Med., 279:1121, 1968.PubMedCrossRefGoogle Scholar
  26. 26.
    Evans, A.S., Niederman, J.C., and Sawyer, R.N. Prospective studies of a group of Yale University freshman. II. Occurrence of acute respiratory infections and rubella. J. Infect. Dis., 123:271, 1971.PubMedCrossRefGoogle Scholar
  27. 27.
    Evans, A.S., Niederman, M.C., Cenabre, L.C., West, B., and Richards, V.A. A prospective evaluation of heterophile and Epstein-Barr virus-specific IgM antibody tests in clinical and subclinical infectious mononucleosis: specificity and sensitivity of the tests and persistence of antibody. J. Inf. Dis., 132:546, 1975.CrossRefGoogle Scholar
  28. 28.
    Evans, A.S. Infectious mononucleosis and related syndromes. Am. J. Med. Sci., 276:325, 1978.PubMedCrossRefGoogle Scholar
  29. 29.
    Evans, A.S. and Niederman, J.C. EBV-IgA and new heterophile antibody tests in diagnosis of infectious mononucleosis. Am. J. Clin. Path., 77:555, 1982.PubMedGoogle Scholar
  30. 30.
    Fiala, M. Heiner, D.C., Turner, J.A., Rosenbloom, B., and Guze, L.B. Infectious mononucleosis and mononucleosis syndromes — clinical, virological and immunological features (Medical Progress). West. J. Med., 126:445, 1977.PubMedGoogle Scholar
  31. 31.
    Finch, S.C. Clinical symptoms and signs of infectious mononucleosis. In: R.L. Carter and H.G. Penman (eds.), Infectious Mononucleosis. p. 19. Oxford: Blackwell, 1969.Google Scholar
  32. 32.
    Finch, S.C. Laboratory findings in infectious mono nucleosis. In: R.L. Carter and H.G. Penman (eds.), Infectious Mononucleosis. p. 64. Oxford: Blackwell, 1969.Google Scholar
  33. 33.
    Fisher, B.D. Neutropenia in infectious mononucleosis. N. Engl. J. Med., 288:633, 1973.PubMedGoogle Scholar
  34. 34.
    Fleisher, G., Lennette, E.T., Henle, G., and Henle, W. Incidence of heterophil antibody responses in children with infectious mononucleosis. J. Ped., 94:723, 1979.CrossRefGoogle Scholar
  35. 35.
    Frishman, W., Krause, M.E., Zabkar, J., Brooks, V., Alonso, D. and Dixon, L.M. Infectious mononucleosis and fatal myocarditis. Chest, 72: 535, 1977.PubMedCrossRefGoogle Scholar
  36. 36.
    Gartner, J.G. and Seemayer, T.A. New oncologic association for the Epstein-Barr virus. Am. J. Surg. Pathol., 6:471, 1982.PubMedCrossRefGoogle Scholar
  37. 37.
    Gerber, P., Nonoyama, M., Lucas, S., Perlin, E. and Goldstein, L.I. Oral excretion of Epstein-Barr virus by healthy subjects and patients with infectious mononucleosis. Lancet, ii:988, 1972.CrossRefGoogle Scholar
  38. 38.
    Gervais, F., Wills, A. Leyritz, M. Lebrum, A., and Joncas, J.H. Relative lack of Epstein-Barr virus (EBV) receptors on B cells from persistent EBV seronegative adults. J. Immunol., 126:897, 1981.PubMedGoogle Scholar
  39. 39.
    Glade, P.R. General features of infectious mononucleosis. In: P.R. Glade (ed.), Infectious Mononucleosis. p. 1. Philadelphia: Lippincott, 1972.Google Scholar
  40. 40.
    Gorlieb-Stematski, T. and Glaser, R. Association of Epstein-Barr virus with neurologic diseases. In: R. Glaser and T. Gotlieb-Stematski (eds.), Human Herpes Virus Infections. Clinical Aspects. p. 169. New York: Dekker, 1982.Google Scholar
  41. 41.
    Gowing, N.F.C. Infectious mononucleosis: histopathologic aspects. In: S.C. Sommer (ed.), Pathology Annual, p. 1. New York: Appleton, 1975.Google Scholar
  42. 42.
    Grose, C., Henle, W., Henle, G., and Feorino, P.M. Primary Epstein-Barr-virus infections in acute neurologic diseases. N. Engl. J. Med., 292:392, 1975.PubMedCrossRefGoogle Scholar
  43. 43.
    Gutgesell, M.P. Acute airway obstruction in infectious mononucleosis. Pediatrics, 47:141, 1971.PubMedGoogle Scholar
  44. 44.
    Hammond, W.P., Harlan, J.M., and Steinberg, S.E. Severe neutropenia in infectious mononucleosis. West. J. Med., 131:92, 1979.PubMedGoogle Scholar
  45. 45.
    Hanto, D.W., Frizzera, G., Purtilo, D.T., Sakamoto, K., Sullivan, J.L., Saemundsen, A.K., Klein, G., Simmons, R.L., and Najarian, J.S. Clinical spectrum of lymphoproliferative disorders in renal transplant recipients and evidence for the role of Epstein-Barr virus. Cancer Res., 41:4253, 1981.PubMedGoogle Scholar
  46. 46.
    Harris, J.T. and Ferguson, A.W. Fatal infectious mononucleosis with liver failure in two sisters. Arch. Dis. Child., 43:480, 1968.CrossRefGoogle Scholar
  47. 47.
    Haynes, B. F., Schooley R.T., Grouse, J.E., Payling-Wright, C.R., Dolin, R., and Fauci, A.S. Characterization of thymus-derived lymphocyte subsets in acute Epstein-Barr virus-induced infectious mononucleosis. J. Immunol., 122:699, 1979.PubMedGoogle Scholar
  48. 48.
    Haynes, B.F., Schooley, R.T., Payling-Wright, C.R., Grouse, J.E., Dolin, R., and Fauci, A.S. Emergence of suppressor cells of immunoglobulin synthesis during acute Epstein-Barr virus induced infectious mononucleosis. J. Immunol., 123:2095, 1979.PubMedGoogle Scholar
  49. 49.
    Henle, W., Henle, G., and Horwitz, C.A. Relation of Burkitt’s tumor-associated herpes-type virus to infectious mononucleosis. Proc. Natl. Acad. Sci. USA, 59:94, 1968.PubMedCrossRefGoogle Scholar
  50. 50.
    Henle, G. and Henle, W. Observations on childhood infections with the Epstein-Barr virus. J. Infect. Dis., 121:303, 1970.PubMedCrossRefGoogle Scholar
  51. 51.
    Henle, W., Henle, G.E., and Horwitz, C.A. Epstein-Barr virus specific diagnostic tests in infectious mononucleosis. Hum. Path.. 5:551, 1974.PubMedCrossRefGoogle Scholar
  52. 52.
    Henle, W., Henle, G., and Lennette, E.T. The Epstein-Barr virus. Sci. Am., 241:48, 1979.PubMedCrossRefGoogle Scholar
  53. 53.
    Hoagland, R.J. and Henson, H.M. Splenic rupture in infectious mononucleosis. Ann. Int. Med., 46:1184, 1957.PubMedGoogle Scholar
  54. 54.
    Hoagland, R.J. Mononucleosis and heart disease. Am. J. Med. Sci., 248:35, 1964.CrossRefGoogle Scholar
  55. 55.
    Hoagland, J.R. Infectious Mononucleosis. New York: Grune and Stratton, 1967.Google Scholar
  56. 56.
    Horwitz, C.A., Henle, W., Henle, G., Palesky, H., Balfour, H.H., Jr., Siera, R.A., Borkin, S., and Ward, P.C. Heterophile negative infectious mononucleosis and mononucleosis-like illnesses. Am. J. Med., 63; 947, 1977.PubMedCrossRefGoogle Scholar
  57. 57.
    Horwitz, C.A., Henle, W. Henle, G., Penn, G., Hoffman, N., and Ward, P.C. Persistent falsely positive rapid tests for infectious mononucleosis. Am. J. Clin. Pathol., 72:807, 1979.PubMedGoogle Scholar
  58. 58.
    Horwitz, C.A., Henle, W., Henle, G., Polesky, H., and Leonardy, J. Spurious rapid infectious mononucleosis test results in non-infectious mononucleosis sera. Am. J. Clin. Pathol., 78:48, 1982.PubMedGoogle Scholar
  59. 59.
    Ho-Yen, D.O. Autoimmune hemolytic anemia complicating infectious mononucleosis in a patient with hereditary ellipocytosis. Acta Haematol., 59: 45, 1978.PubMedCrossRefGoogle Scholar
  60. 60.
    Hovde, R.F. and Sundberg, R.O. Granulomatous lesions in the bone marrow in infectious mononucleosis. Blood, 5:209, 1950.PubMedGoogle Scholar
  61. 61.
    Hudgins, J.M. Infectious mononucleosis complicated by myocarditis and pericarditis. J. Am. Med. Assoc., 235:2626, 1976.CrossRefGoogle Scholar
  62. 62.
    Hutt, L.M., Huang, Y.T., Discomb, H.E., and Pagano, L.S. Enhanced destruction of lymphoid cell lines by peripheral blood leukocytes taken from patients with acute infectious mononucleosis. J. Immunol., 115:243, 1975.PubMedGoogle Scholar
  63. 63.
    Hunt-Fletcher, L.M. The functions of atypical lymphocytes. In: H. Waters, (ed.), The Handbook of Cancer Immunology. Vol. 6, p. 127. Lymphoid Cell Subpopulations: Structure, Function and Interactions. New York: Garland STPM Press, 1981.Google Scholar
  64. 64.
    Jondal, M. and Klein, G. Surface markers on human B and T lymphocytes. II. Presence of Epstein-Barr virus receptors on B lymphocytes. J. Exp. Med., 138:1365, 1973.PubMedCrossRefGoogle Scholar
  65. 65.
    Jondal, M., Klein, G., Oldstone, M.B.A., Bokish, V., and Hefenof, E. Surface markers on human B and T lymphocytes VIII. Association between complement and Epstein-Barr virus receptors on human lymphoid cells. Scand. J. Immunol., 5:401, 1976.PubMedCrossRefGoogle Scholar
  66. 66.
    Kano, K. and Milgrom, F. Heterophil antigens and antibodies in medicine. Cur. Top. Microbiol. Immunol., 77:43, 1977.CrossRefGoogle Scholar
  67. 67.
    Kemola, E., von Essen, R., Henle, G., and Henle, W. Infectious-mononucleosis-like disease with negative heterophile agglutination test. Clinical features in relation to Epstein-Barr virus and cytomegalovirus antibodies. J. Infect. Dis., 121: 608, 1970.CrossRefGoogle Scholar
  68. 68.
    Kilpatrick, Z.M. Structural and functional abnormalities of liver in infectious mononucleosis. Arch. Int. Med., 117:47, 1966.CrossRefGoogle Scholar
  69. 69.
    Klein, G., Svedmyre, E., Jondal, M., and Persson, P.O. EBV-determined nuclear antigen (EBNA)-positive cells in the peripheral blood of infectious mononucleosis patients. Int. J. Cancer, 17:21, 1976.PubMedCrossRefGoogle Scholar
  70. 70.
    Kostinas, J.E. and Cantow, E.F. Studies on infectious mononucleosis. II. Autohemolysis. Am. J. Med. Sci., 252:296, 1966.PubMedCrossRefGoogle Scholar
  71. 71.
    Koziner, B., Hadler, N., Parillo, J., and Ellman, L. Agranulocytosis following infectious mononucleosis. J. Am. Med. Assoc, 225:1235, 1973.CrossRefGoogle Scholar
  72. 72.
    Lee, C.L., Davidsohn, I., and Panczyszyn, O. Horse agglutinins in infectious mononucleosis. II. The Spot Test. Am. J. Clin. Pathol., 49:12, 1968.PubMedGoogle Scholar
  73. 73.
    Lee, C.L., Zandrew, F., and Davisohn, I. Horse agglutinins in infectious mononucleosis. I. Am. J. Clin. Path., 49:3, 1968.Google Scholar
  74. 74.
    Lennette, E.T., Henle, G., Henle, W., and Horowitz, C.A. Heterophile antigen in bovine sera detectable by immune adherence hemagglutination with infectious mononucleosis sera. Inf. Immun., 19:923, 1978.Google Scholar
  75. 75.
    Martin, M.F.R. Atypical infectious mononucleosis with bone marrow granuloma and pancytopenia. Br. Med. J., 2:200, 1977.CrossRefGoogle Scholar
  76. 76.
    McCurdy, J.A. Life-threatening complications of infectious mononucleosis. Laryngoscope, 85:1557, 1975.PubMedCrossRefGoogle Scholar
  77. 77.
    McKenna, R.W. Infectious mononucleosis: part 1. Morphologic Aspects. Lab. Med., 10:135, 1979.Google Scholar
  78. 78.
    Merril, R.H., Barrett, O.N., and Barrett, M.C. Positive monospot test in histiocytic medullary reticulosis. Am. J. Clin. Pathol., 65:407, 1976.Google Scholar
  79. 79.
    Miller, G., Niederman, J.C., and Andrews, L.L. Prolonged oropharyngeal excretion of Epstein-Barr virus after infectious mononucleosis. N. Engl. J. Med., 288:229, 1973.PubMedCrossRefGoogle Scholar
  80. 80.
    Moir, J.I. Glandular fever in the Falkland Islands. Br. Med. J., 2:822, 1930.CrossRefGoogle Scholar
  81. 81.
    Mundy, G.R. Infectious mononucleosis with pulmonary parenchymal involvement. Br. Med. J., 1:219, 1972.CrossRefGoogle Scholar
  82. 82.
    Mir, M.A. and Delamore, I.W. Aplastic anaemia complicating infectious mononucleosis. Scand. J. Haemat., 11:314, 1973.Google Scholar
  83. 83.
    Niederman, J.C., McCallum, R.W., Henle, G., and Henle, W. Infectious mononucleosis. Clinical manifestations in relation to EB virus antibodies. J. Med. Am. Assoc, 203:205, 1968.CrossRefGoogle Scholar
  84. 84.
    Nikoskelainen, J., Leikola, J., and Kemola, E. IgM antibodies specific for Epstein-Barr virus in infectious mononucleosis without heterophile antibodies. Br. Med. J., 4:72, 1974.PubMedCrossRefGoogle Scholar
  85. 85.
    Ophoven, J. Infectious mononucleosis: part 2. Serologic aspects. Lab. Med., 10:203, 1979.Google Scholar
  86. 86.
    Pattengale, P.K., Smith, R.W., and Perlin, E. Atypical lymphocytes in acute infectious mononucleosis — Identification by multiple T and B lymphocyte markers. N. Engl. J. Med., 291:1145, 1974.PubMedCrossRefGoogle Scholar
  87. 87.
    Paul, J.R. and Bunnell, W.W. The presence of heterophile antibodies in infectious mononucleosis. Am. J. Med. Sci., 183:90, 1932.CrossRefGoogle Scholar
  88. 88.
    Penman, H.G. Fatal infectious mononucleosis: a critical review. J. Clin. Pathol., 23:765, 1970.PubMedCrossRefGoogle Scholar
  89. 89.
    Pullen, H Wright, N., and Murdoch, J.M. Hypersensitivity reactions to antibacterial drugs in infectious mononucleosis. Lancet, ii: 1176, 1967.Google Scholar
  90. 90.
    Pullen, H., Wright, N., and Murdoch, J.M. Hypersensitivity to penicillins. Lancet, 1:1090, 1968.PubMedCrossRefGoogle Scholar
  91. 91.
    Purtilo, D.T., Cassel, C.K., Yang, H.P.S., Harper, R. Stephenson, S.R., Landing, B.H., and Vawter, G.F. X-linked recessive progressive combined variable immunodeficiency (Duncan’s disease). Lancet, i:935, 1975.CrossRefGoogle Scholar
  92. 92.
    Purtilo, D.T. Immunopathology of infectious mononucleosis and other complications of Epstein-Barr virus infections. In: S.C. Sommers and P.P. Rosen (eds.), Pathology Annual. pp. 253–299. New York: Appleton-Century-Croft, 1980.Google Scholar
  93. 93.
    Purtilo, D.T. Immune deficiency predisposing to Epstein- Barr virus induced lymphoproliferative diseases. The X-linked lymphoproliferative syndrome as a model. In: G. Klein and S. Weinhouse (eds.), Advances in Cancer Research. Vol. 34, pp. 279–312. New York: Academic Press, 1981.CrossRefGoogle Scholar
  94. 94.
    Purtilo, D.T. and Klein, G. (eds.) Symposium on Epstein-Barr virus-induced lymphoproliferative diseases in immunode-ficient patients. Cancer Res., 41:209, 1981.Google Scholar
  95. 95.
    Purtilo, D.T. and Sakamoto, K. Epstein-Barr virus and human disease: immune responses determine the clinical and pathologic expression. Hum. Pathol., 12: 677, 1981.PubMedCrossRefGoogle Scholar
  96. 96.
    Radel, E.G. and Schorr, J.B. Thrombocytopenic purpura with infectious mononucleosis. J. Pediat., 63:46, 1963.PubMedCrossRefGoogle Scholar
  97. 97.
    Reitman, M.J., Zirin, J.H., and De Angelis, C.J. Complete heart block in Epstein-Barr myocarditis. Pediat., 62:847, 1978.Google Scholar
  98. 98.
    Robinson, J. Mitotic EBNA-positive lymphocytes in peripheral blood during infectious mononucleosis. Nature, 287:334, 1980.PubMedCrossRefGoogle Scholar
  99. 99.
    Royston, I., Sullivan, J.L., Periman, P.O., and Perlin, E. Cell-mediated immunity to Epstein-Barr virus-transformed lymphoblastoid cells in acute infectious mononucleosis. N. Engl. J. Med., 293:1159, 1975.PubMedCrossRefGoogle Scholar
  100. 100.
    Rutkow, J.M. Rupture of the spleen in infectious mono nucleosis. Arch. Surg., 113:718, 19781.Google Scholar
  101. 101.
    Salvador, A.H., Harrison, E.G., and Kyle, R.A. Lymphadenopathy due to infectious mononucleosis: its confusion with malignant lymphoma. Cancer, 27: 1029, 1971.PubMedCrossRefGoogle Scholar
  102. 102.
    Sawyer, R.N., Evans, A.S., Niederman, J.C., and McCallum, R.W. Prospective studies on a group of Yale University freshman. I. Occurrence of infectious mononucleosis. J. Infect. Dis., 123:263, 1971.PubMedCrossRefGoogle Scholar
  103. 103.
    Schmitz, H. and Scherer, M. IgM antibodies to Epstein-Barr virus in infectious mononucleosis. Archiv fur gstarnte Virusforschung, 37:32, 1972.Google Scholar
  104. 104.
    Shadduck, R.K., Winkelstein, A., Zeigler, Z., Lichtner, J. Goldstein, M., Michaels, M., and Rabin, B. Aplastic anemia following infectious mononucleosis. Possible immune etiology. Exp. Hematol., 7:264, 1979.PubMedGoogle Scholar
  105. 105.
    Shiftan, T.A. and Mendelshohn, J. The circulating “atypical” lymphocyte. Hum. Path., 9:51, 1978.PubMedCrossRefGoogle Scholar
  106. 106.
    Silverstein, A. Steinberg, G., and Nathanson, M. Nervous system involvement in infectious mononucleosis — The heralding and/or major manifestation. Arch. Neurol., 26: 353, 1972.PubMedCrossRefGoogle Scholar
  107. 107.
    Sprunt, T.P. and Evans, F.A. Mononuclear leukocytosis in reaction to acute infections (“infectious mononucleosis”). Bull. Hopkins Hosp., 31:410, 1938.Google Scholar
  108. 108.
    Svedmyr, E., Jondal, M., Henle, W., Weiland, O., Rombo, L., and Klein, G. EBV-specific killer T-cells and serologic responses after onset of infectious mononucleosis. J. Clin. Lab. Immunol., 1: 225, 1978.PubMedGoogle Scholar
  109. 109.
    Tamir, D., Benderly, A., Levy, J., Ben-Parath, E., and Vonsover, A. Infectious mononucleosis and Epstein-Barr virus in childhood. Pediatric, 53: 330, 1974.Google Scholar
  110. 110.
    Tosato, G., Magrath, I., Koski, I., Dooley, N., and Blaese, M. Activation of suppressor T cells during Epstein-Barr-virus-induced infectious mononucleosis. N. Engl. J. Med., 301:1134, 1979.CrossRefGoogle Scholar
  111. 111.
    Troxel, D.B., Innella, F., and Cohen, R.J. Infectious mononucleosis complicated by hemolytic anemia due to anti-i. Am. J. Clin. Path., 46:625, 1966.Google Scholar

Copyright information

© Plenum Publishing Corporation 1984

Authors and Affiliations

  • James Linder
    • 1
  • David T. Purtilo
    • 1
  1. 1.Department of Pathology and Laboratory MedicineUniversity of Nebraska Medical CenterOmahaUSA

Personalised recommendations