What is the duration for liver function tests (LFT) to normalize after infectious mononucleosis?

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From the Research

Liver function tests (LFTs) typically return to normal within 8 weeks after infectious mononucleosis, with a range of 6-12 weeks, according to the most recent and highest quality study 1. The recovery time for LFTs to return to normal can vary depending on the severity of the infection, the patient's overall health, and individual immune response.

  • The most common liver abnormalities seen in mono include elevated transaminases (ALT and AST), which can reach 2-3 times the upper limit of normal, and mild elevations in bilirubin and alkaline phosphatase.
  • These abnormalities occur because the Epstein-Barr virus (EBV), which causes mono, can directly infect liver cells and trigger an immune response that leads to hepatic inflammation.
  • No specific medications are needed to normalize LFTs in uncomplicated mono; they typically improve spontaneously as the infection resolves.
  • Patients should avoid alcohol and hepatotoxic medications during recovery to prevent additional liver stress.
  • If LFTs remain significantly elevated beyond 3-6 months, further evaluation may be warranted to rule out other liver conditions or complications, as suggested by other studies 2, 3, 4, 5. However, the most recent and highest quality study 1 provides the most accurate estimate of the time it takes for LFTs to return to normal after infectious mononucleosis.

References

Research

The utility of liver function tests and abdominal ultrasound in infectious mononucleosis-A systematic review.

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2022

Research

Infectious Mononucleosis: An Updated Review.

Current pediatric reviews, 2024

Research

Infectious Mononucleosis: Rapid Evidence Review.

American family physician, 2023

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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