Structural and functional abnormalities of liver in infectious mononucleosis

Abstract

Liver-function tests and liver biopsies were performed on 20 consecutive military patients with infectious mononucleosis. The histologic changes seen on biopsy sections were graded to reflect the extent of sinusoidal infiltration by mononuclear cells. When these findings were compared to the results of sulfobromophthalein (BSP), serum glutamic pyruvic transaminase (SGPT), and serum alkaline phosphatase (SAP) determinations, a very good correlation was found between the severity of the infiltrative process and the frequency of abnormal liver-function tests. Patients whose biopsies showed a minor degree of sinusoidal infiltration had BSP, SGPT, and serum alkaline phosphatase determinations that were normal or slightly elevated. When extensive infiltrative lesions were present, BSP, SGPT, and SAP values were significantly elevated. It further appeared that more patients with extensive infiltrative lesions had total WBC of 15,000/cu mm or more and relative lymphocytomatosis of 70% and greater than did patients with minor infiltrative changes. It is suggested that significant abnormalities in the BSP, SGPT, and SAP tests might serve to predict severe mononuclear round-cell infiltration of the hepatic lobular sinusoids.