[Heterophil antibody negative infectious mononucleosis due to Epstein-Barr virus. A clinical, hematological and serological study of 14 cases (author's transl)].
Fourteen patients admitted to the hospital for heterophil antibody negative infectious mononucleosis (IM) were studied; the causative agent was Epstein-Barr virus, as confirmed by the presence of anti-VCA antibodies (IgG and IgM) and the absence of anti-EBNA antibodies. The patients were from 2 to 69 years old, 7 being less than 10 years old while 4 were more than 45 years old. In all cases, asthenia and adenopathy were found and a deterioration in liver functions was present whenever it was looked for; jaundice occurred in 3 patients. In 6 cases fever persisted for several weeks. Leukocytosis and a high level of mononuclear cells were present in 8 patients and atypical lymphocytes in 10. Anti-EA titers were found to be high in the severe forms of illness. Clinical and laboratory features of these 14 heterophil negative IM patients were compared with a group of 21 heterophil positive IM patients studied under the same conditions; the most striking differences between the two groups were the frequency of patients under 10 and over 45 years old in the heterophil negative group, the frequency of abnormal liver function tests and of persistent fever, and a lower frequency of atypical lymphocytes.