Epstein–Barr Virus-Induced Mononucleosis as an Imitator of Severe Preeclampsia

Abstract

Background In pregnancy, conditions presenting with hematologic abnormalities, transaminitis, and proteinuria pose diagnostic challenges in pregnancy.

Case We present the case of an 18-year-old woman, G1P0, at 33 weeks' gestation with fever of unknown cause, who developed progressively elevated liver enzymes, proteinuria, and thrombocytopenia, due to Epstein–Barr virus (EBV) infection.

Conclusion Acute infection with EBV should be included in the differential diagnosis of preeclampsia with severe features, particularly in the setting of fever. Supportive treatment and observation may prevent iatrogenic preterm birth.

Keywords

preeclampsia - mononucleosis - preterm birth - maternal - thrombocytopenia

Summary

EBV-induced mononucleosis may imitate signs and symptoms of preeclampsia with severe features and should be considered in the differential diagnosis, particularly in setting of fever.

Teaching Points

1. EBV may imitate preeclampsia with severe features and place women at risk for spontaneous and iatrogenic preterm birth.

2. Expectant management and supportive treatment are preferred in pregnant women with mononucleosis, and this form of management may prevent iatrogenic preterm birth.

3. Active infection with EBV is a contraindication to breastfeeding, but not once the patient is postviral.

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