Since the first published necropsy report of a case of infectious mononucleosis with acute hepatitis by Ziegler,1 numerous investigators have firmly established the common association of hepatitis with this disease.2-18 With the more widespread use of liver biopsies in the acute stage of mononucleosis, it became increasingly clear that the majority of cases had histologic features of focal and diffuse intralobular infiltrates with little, if any, distortion of hepatic architecture.19-21 However, there has also been evidence of a more severe process, in that the hepatitis of infectious mononucleosis has been at times histologically indistinguishable from that of viral hepatitis.22-27
One of the "liver function" tests frequently employed has been the serum alkaline phosphatase. Elevations of this enzyme have been reported in 35% to 88% of cases with infectious mononucleosis.* Of interest have been the occasionally reported instances of pronounced serum alkaline phosphatase activity in patients with
FUTTERWEIT W. Serum Alkaline Phosphatase Activity in Infectious Mononucleosis: A Clinical Study of Fifty-Five Cases. Arch Intern Med. 1961;108(2):253–268. doi:10.1001/archinte.1961.03620080085009
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