Nature of Hepatitis in Infectious Mononucleosis in Patients of Different Age with Typical and Subclinical Signs of the Disease

Enlarged liver and spleen — one of the cardinal syndromes of infectious mononucleosis (IM), so figuring out the frequency, nature and severity of hepatitis in children and adults with IM with typical and subclinical manifestations of peripheral lymphadenopathy is relevant. The study was carried out in 135 patients with IM of different age: from 1 to 7 years — 80 persons; from 7 to 18 years — 25 and 18 years and older — 30. All patients underwent the general study of the blood, serologic examination for detection of IgM antibodies to Epstein — Barr virus (EBV) by ELISA and/or polymerase chain reaction for the presence of EBV and cytomegalovirus DNA in peripheral blood, biochemical blood tests (to determine the activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), levels of total bilirubin and its fractions, alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT)), identification of markers of viral hepatitis, ultrasound examination of internal organs. It is shown that among patients with IM hepatomegaly is most significant in children younger than 7 years. Mild jaundice associated with moderate increase in both fractions of bilirubin, occurs in about one of ten patients and was more common in children up to 7 years. At the same time, an increase of transaminases activity was observed significantly more frequently in adult patients compared to patients with children and was detected with equal frequency in patients with typical and atypical manifestations of lymphadenopathy. Prevailing mild increased activity of enzymes (ALT, AST, GGT, ALP), a small violation of bilirubin metabolism indicate some transient disturbances in the functional capacity of the liver in IM, caused by concomitant reversible acute hepatitis of low or moderate activity