Gallbladder wall thickening in mononucleosis syndromes.

OBJECTIVE

We used sonography to measure gallbladder wall thickness in patients with mononucleosis syndromes and then evaluated laboratory data, spleen size, and clinical evolution to assess any relationship between gallbladder wall thickening (GBWT) and the severity of disease.

METHODS

We retrospectively reviewed the medical records, sonograms, and sonographic reports of 39 patients who were diagnosed with mononucleosis syndromes on the basis of fever, tonsillopharyngitis, cervical adenopathy, hepatosplenomegaly, and lymphocytosis with atypical lymphocytes. All 39 were included in the study. The gallbladder wall thickness in each patient was sonographically determined. GBWT was defined as a wall thickness exceeding 3 mm. We assessed the laboratory data and clinical evolution in each patient, and the differences between patients with and without GBWT were statistically analyzed.

RESULTS

Six patients (15%) had GBWT. The mean atypical lymphocyte count +/- standard deviation (SD) in the patients with GBWT (1,830/microl +/- 1,000/microl) was significantly higher than that in patients without GBWT (1,140/microl +/- 660/microl; p < 0.05). The mean total serum protein and serum albumin levels in the patients with GBWT (6.6 mg/dl +/- 0.7 mg/dl and 3.7 mg/dl +/- 0.5 mg/dl, respectively) were significantly lower than those in patients without GBWT (7.3 mg/dl +/- 0.4 mg/dl and 4.1 mg/dl +/- 0.3 mg/dl, respectively; p < 0.05). The duration of hospitalization in the patients with GBWT (14 +/- 8.5 days) was significantly higher than that in patients without GBWT (8 +/- 3.5 days; p < 0.05).

CONCLUSIONS

GBWT in mononucleosis syndromes may be a sign of the severity of the illness and when present indicates the need to carefully monitor the clinical course.