Although infectious mononucleosis is usually a relatively benign disease, complications sometimes occur. Skin eruption, hepatitis, splenic rupture, myocarditis, pulmonary infiltration, central nervous system involvement, hemolytic anemia, and thrombocytopenia have all been reported. Splenic rupture has probably been the most frequent fatal complication.
Thrombocytopenic purpura is one of the most uncommon complications, but due to the potential danger of cerebral and other hemorrhage and because of the favorable response to treatment it is important to recognize the condition early. In reported cases1-6 with only symptomatic treatment thrombocytopenia persisted up to 14 days before spontaneous recovery. In the single reported case treated with adrenocorticotropin 7 recovery was much more rapid.
Adrenocorticotropin or cortisone has been used in toxic cases of infectious mononucleosis without thrombocytopenia 8-11 with good results. Typical response was disappearance of fever and increase in strength and appetite, all within 12 hours, and rapid diminution in size of liver
MYATT AV, LINN RH. Thrombocytopenia Due to Infectious Mononucleosis: Response to Cortisone. AMA Arch Intern Med. 1957;99(1):139–141. doi:https://doi.org/10.1001/archinte.1957.00260010141016
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