Acute infectious mononucleosis is caused by the Epstein-Barr virus (EBV), which infects B lymphocytes and thereby elicits a strong immune response dominated by activated and proliferating CD8+ T cells. It mainly affects teenagers and young adults, and can cause fatigue, fever, malaise, splenomegaly, hepatitis, and lymphadenopathy.1 We recently observed a 35-year-old man who presented with the above-mentioned symptoms and had the typical serologic (positive VCA-IgM titer) and hematologic findings of an acute infectious mononucleosis. He showed a massive lymphocytosis (6×109/L), which was mainly due to a CD8-cell expansion (Table). The majority of circulating CD8 cells was activated as revealed by expression of HLA-DR. To analyze whether this strong T-cell immune response is oligoclonal or polyclonal, we stained the peripheral blood mononuclear cells with T-cell receptor (TCR)-Vβ-chain-specific antibodies. During the acute phase of the disease, an expansion of one of the TCR-Vβ families on CD8 cells was observed
Pichler WJ, Mauri-Hellweg D, Baumann K, Bettens F. Selective Expression of T-Cell Receptor-Vß in Acute Infectious Mononucleosis. Arch Intern Med. 1995;155(14):1555–1556. doi:10.1001/archinte.1995.00430140135019
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