Fatal aplastic anaemia complicating infectious mononucleosis. A case report with brief review of literature

Abstract

A 9-year old girl suffering from infectious mononucleosis with fatal aplastic anaemia was reported. It was the second Chinese patient in Singapore with a positive heterophil antibody response. A review of the literature showed that aplastic anaemia was a very rare complication of infectious mononucleosis. Up to 1978, only 9 other cases were found in the English Literature. Amongst these 10 cases, there were 7 males and 3 females. The age distribution ranged from 7 to 30 years old. Not all cases had clinical features typical of infectious mononucleosis. These cases were diagnosed by the presence of atypical mononuclear cells in the peripheral blood films with or without a positive heterophil antibody response. In other words, infectious mononucleosis should be considered in any case of unexplained aplastic anaemia. The presence of pancytopenia is prognostically bad for patients with infectious mononucleosis. Amongst these 10 cases, only 6 survived. Overwhelming septicaemia was the cause of death in 4 patients.