A Syndrome Resembling Infectious Mononucleosis After Splenectomy for Idiopathic Thrombocytopenic Purpura

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Abstract
Three cases of an illness resembling infectious mononucleosis were observed during convalescence from splenectomy for idiopathic thrombocytopenic purpura (ITP) during a 10 year period. The ITP was chronic in 2 of the cases, and acute in 1. Thirty-four splenectomies for ITP (21 chronic, 13 acute) were done at the Henry Ford Hospital from January, 1955, to February, 1965. Therefore, the incidence of "an infectious mononucleosis syndrome" occurring after splenectomy for ITP was 8.9%, or 14.3% in the susceptible age group (under 45). This represents an incidence equal to all other post-surgical febrile complications, which occurred in this group. No additional case of an infectious mononucleosis-like illness was found during convalescence, in a review of the 298 splenectomies done for other reasons during this 10 year period. Attention is drawn to the similarity of this observation and the febrile complications associated with "atypical" lymphocytes described by others following thoracotomies for tuberculosis and cardiotomies with extracorporeal circulation. Theoretical considerations are discussed and attention is drawn to this previously unreported occurrence and high incidence of "an infectious mononucleosis syndrome" appearing 3 to 5 weeks after splenectomy for ITP.