multiple sclerosis could be prevented by exposing children to Epstein Barr

Multiple sclerosis could be prevented by exposing

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multiple sclerosis could be prevented by exposing children to Epstein-Barr virus infection before adolescence. 19 Is there an increased risk of lymphoma or other cancers after infectious mononucleosis? The association of Epstein-Barr virus with malignancies such as Burkitt’s lymphoma w66 in children and nasopharyn- geal carcinoma w67 is well established. This review, however, focuses on patients presenting with infectious mononucleo- sis and it can be difficult to differentiate studies on Epstein- Barr virus and infectious mononucleosis about the risk of future malignancies. Two large Scandinavian cohort studies found a 2.55 to 2.83 times increased risk of Hodgkin’s lym- phoma in patients with a diagnosis of infectious mononu- cleosis by heterophile antibody tests. 21 w68 The results were similar in a recent British record linkage paper, which found a 3.44 risk ratio of Hodgkin’s lymphoma in the infectious mononucleosis cohort. 22 A review on Epstein-Barr virus related malignancies from 2014 commented that Hodgkin’s lymphoma is the only Epstein-Barr virus related malignancy, other than nasopharyngeal carcinoma, for which there is a body of evidence accumulated over time that establishes a strong association. w69 For other malignancies, a large pro - spective study found no clear association between a history of clinical infectious mononucleosis and risk of invasive breast cancer, w70 and one of the cohort studies found that lung cancer was significantly less likely in the cohort with infectious mononucleosis. w71 Can infectious mononucleosis cause any complications? Infectious mononucleosis in most cases resolves over a period of weeks, but may occasionally be exacerbated by a wide variety of complications. A list of complications can be found at . Neuro- logical disorders may occur in 1-5% of patients. w72 Theses include encephalitis, meningoencephalitis, seizures, optic neuritis, sudden sensorineural hearing loss, idiopathic facial palsy, and Guillain-Barré syndrome among others. w73 Haematological complications are more common, in par- ticular haemolytic anaemia (3%) and thrombocytopenia (25-50%), w72 but also, rarely, aplastic anaemia, pancyto- penia, and agranulocytosis. Other rare acute complica- tions include myocarditis, pericarditits, w74 pancreatitis, interstitial pneumonia, rhabdomyolysis, and psychologi- cal complications (“Alice in Wonderland” syndrome). The strength of association of infectious mononucleosis with many of these complications is based on scattered case reports, and the evidence of causation in many instances is unconvincing. w72 occur in the initial three weeks of infectious mononucleo- sis, although cases have been described much later. w60 Cases of spontaneous splenic rupture have also been described in the literature and doctors should have a high index of suspicion when abdominal pain is reported in the setting of infectious mononucleosis.
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  • Fall '18
  • infectious mononucleosis, Herpesviridae

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