How is lymphocytosis characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Updated: Sep 20, 2018
  • Author: Burke A Cunha, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Lymphocytosis is one of the classic hematological abnormalities associated with EBV infectious mononucleosis. Relative lymphocytosis (≥ 60%) plus atypical lymphocytosis (≥ 10%) are the characteristic findings of EBV infectious mononucleosis. The causes of heterophile-negative infectious mononucleosis rarely, if ever, have a relative lymphocytosis in excess of 60%. However, in contrast, atypical lymphocytosis is a common feature of any agent responsible for heterophile-negative infectious mononucleosis. The important differential diagnostic point is that the atypical lymphocytosis of EBV infectious mononucleosis is not simply equal to or greater than 10% but is frequently equal to or greater than 30%. An important point is that EBV infectious mononucleosis is more likely to be the cause of atypical lymphocytosis in patients with infectious mononucleosis with greater degrees of atypical lymphocytosis.

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