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Infectious Diseases

Anemia & mononucleosis

06/10/2004

Question:

I`m 26 years old. EBV virus resluts showed that I probably had mononucleosis in the past (EBV EA 52 U/ml, EBV EBNA >200U/ml, EBV VCA IgG 169 U/ml, EBV VCA IgM - NEGATIVE). I`ve also had anemia for over two years now with LYMP 53% and eritrocytes, Hgb, Ht somewhat below normal values. Atypical lymphocytes have also been found. Noone told me the cause of this anemia although I`d went to see hemathologist. I`ve also done all the tests to exclude HIV, hepatitis and other viruses and nothing of that was found. However, my RF (reuma factor) was 90 IU/l. I`ve also done the test for immunotype peripherial blood and it meassured that there are 23% of T-cells and 2.5% of B-cells. Other results of that test were: CD5-LEU1-76%, CD19-LEU12-8.0%, CD23-LEU20-3.0, KAPPA 4.5, LAMBDA 4.0 (there were 76% of T-cells and 8% of B-cells in lymphocytes cells. I really don`t understand what that means and how is all that connected. I know that incubation period for developing mononucleosis after being exposed to EBV virus is few weeks. However, is it possible that this anemia is a result of a virus being in the body or there is a chance that it has nothing to do with the EBV virus? Can atypical lymphocytes be present if no mononucleosis had been developed from the virus? If I got over mononucleosis then why do I still have atypical lymphocytes present in my blood? Is there any way to know the time when mononucleosis was acute? I`m very interested in this information because I still feel quite fatigued and I thought I had anxiety/depression disorder and now I think that there may be a chance that it was caused by a psyhical problem. I still feel tired so could this be from anemia or some other cause I`ve mentioned? How can you tell if the mono is chronic? Is there a test for it? I thank you for Your time and apologise for this long question.

Answer:

The length of the question is not the problem. The real issue is the complex nature of the problems you are having. It is really not possible to sort out all the possibilities in an email response. You do need, however, to be sure that you get more information. I would suggest that you see someone in Infectious Diseases (mono or other virus) and, if your blood counts are then abnormal, perhaps a hematologist. The complexities are too great for an easy email response that would satisfy your needs.

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Response by:

Gary   Roselle, MD Gary Roselle, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati