Riddle Me This: Acalculous Cholecystitis as an Unusual Complication of Immunoglobulin M Negative Mononucleosis

被引：3

作者：

Hoehn, Philipp ^{[1
]}

Braumann, Chris ^{[1
]}

Uhl, Waldemar ^{[1
]}

Luu, Andreas M. ^{[1
]}

机构：

[1] Ruhr Univ Bochum, St Josef Hosp, Katholisches Klinikum Bochum, Dept Gen & Visceral Surg, Bochum, Germany

来源：

CUREUS | 2018年 / 10卷 / 04期

关键词：

infectious mononucleosis; splenectomy; acalculous cholecystitis; epstein-barr virus (ebv);

D O I：

10.7759/cureus.2505

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Infectious mononucleosis is a common disease of the adolescent caused by the Epstein-Barr virus (EBV). We present a rare case of a male adult with acalculous cholecystitis due to infectious mononucleosis. A correct diagnosis was challenging due to a false negative antibody test. Laboratory values were significant for a marked lymphocytosis and an early Immunoglobulin G (IgG) response without initial Immunoglobulin M (IgM) elevation. However, IgM antibodies were elevated two weeks later. Symptoms resolved quickly under symptomatic therapy. Antibody level patterns in asplenic patients with infectious mononucleosis are characterized by an atypical course with a delayed rise in IgM antibodies, which complicates the correct diagnosis of an EBV-induced acalculous cholecystitis.

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相关论文

共 9 条

[1] HETEROPHIL ANTIBODY IN ADULTS WITH SORE THROAT - FREQUENCY AND CLINICAL PRESENTATION [J].

ARONSON, MD ;

KOMAROFF, AL ;

PASS, TM ;

ERVIN, CT ;

BRANCH, WT .

ANNALS OF INTERNAL MEDICINE, 1982, 96 (04) :505-508

[2] Infectious mononucleosis [J].

Balfou, Henry H., Jr. ;

Dunmire, Samantha K. ;

Hogquist, Kristin A. .

CLINICAL & TRANSLATIONAL IMMUNOLOGY, 2015, 4

[3] Postsplenectomy Cytomegalovirus Mononucleosis is a Distinct Clinicopathologic Syndrome [J].

Han, Xiang Y. ;

Hellerstedt, Beth A. ;

Koller, Charles A. .

AMERICAN JOURNAL OF THE MEDICAL SCIENCES, 2010, 339 (04) :395-399

[4] Marked lymphocytosis, TCRγ gene rearrangements, and impaired IgM response [J].

Han, XY ;

Lin, P ;

Amin, HM ;

Ferrajoli, A .

AMERICAN JOURNAL OF CLINICAL PATHOLOGY, 2005, 123 (04) :612-617

[5] INFECTIOUS MONONUCLEOSIS IN A GENERAL POPULATION [J].

HEATH, CW ;

BRODSKY, AL ;

POTOLSKY, AI .

AMERICAN JOURNAL OF EPIDEMIOLOGY, 1972, 95 (01) :46-+

[6]

Kaslow RA, 2014, VIRAL INFECT HUMANS, V27, P3, DOI [DOI 10.1007/978-1-4899-7448-8_1, 10.1007/978-1-4899-7448-8_1]

[7] Human immunoglobulin M memory B cells controlling Streptococcus pneumoniae infections are generated in the spleen [J].

Kruetzmann, S ;

Rosado, MM ;

Weber, H ;

Germing, U ;

Tournilhac, O ;

Peter, HH ;

Berner, R ;

Peters, A ;

Boehm, T ;

Plebani, A ;

Quinti, I ;

Carsetti, R .

JOURNAL OF EXPERIMENTAL MEDICINE, 2003, 197 (07) :939-945

[8] Normal IgG and impaired IgM responses to polysaccharide vaccines in asplenic patients [J].

Molrine, DC ;

Siber, GR ;

Samra, Y ;

Shevy, DS ;

MacDonald, K ;

Cieri, R ;

Ambrosino, DM .

JOURNAL OF INFECTIOUS DISEASES, 1999, 179 (02) :513-517

[9] Human blood IgM "memory" B cells are circulating splenic marginal zone B cells harboring a prediversified immunoglobulin repertoire [J].

Weller, S ;

Braun, MC ;

Tan, BK ;

Rosenwald, A ;

Cordier, C ;

Conley, ME ;

Plebani, A ;

Kumararatne, DS ;

Bonnet, D ;

Tournilhac, O ;

Tchernia, G ;

Steiniger, B ;

Staudt, LM ;

Casanova, JL ;

Reynaud, CA ;

Weill, JC .

BLOOD, 2004, 104 (12) :3647-3654