From the Research
Yes, mononucleosis (mono) can suppress platelets, as evidenced by a recent study published in 2023 1. This viral infection, typically caused by the Epstein-Barr virus, can lead to thrombocytopenia, a condition characterized by abnormally low platelet counts. During mono infection, the virus can trigger an immune response that mistakenly attacks platelets or interferes with their production in the bone marrow.
Key Findings
- Thrombocytopenia was present in 29.7% of patients with infectious mononucleosis, with 8.0% showing platelet counts lower than 100 ×10^9/L 1.
- The suppression is usually temporary and resolves as the infection clears, with platelet counts significantly increasing during follow-up, even in cases without baseline thrombocytopenia 1.
- Patients with mono-related thrombocytopenia may experience symptoms like easy bruising, petechiae (small red or purple spots on the skin), or in severe cases, bleeding.
- Most cases are mild and don't require specific treatment beyond managing the underlying mono infection, but regular blood count monitoring is important during mono infection, especially if there are signs of bleeding or bruising.
Clinical Implications
- If platelet counts drop significantly (below 20,000 per microliter) or if bleeding occurs, medical intervention may be necessary.
- The platelet suppression typically improves within 2-4 weeks as the body recovers from the viral infection.
- A recent review published in 2024 2 highlights the importance of prompt diagnosis and management of infectious mononucleosis to avoid unnecessary investigations and treatments and to minimize complications.
Management
- Treatment is mainly supportive, with reduction of activity and bed rest as tolerated recommended 2.
- Patients should be advised to avoid contact sports or strenuous exercise for 8 weeks or while splenomegaly is still present 2.
- In severe cases of thrombocytopenia, corticosteroids like prednisone may be used to manage the condition, as reported in a case study from 1976 3.