From the Research
Yes, platelets can be low in infectious mononucleosis (mono), with thrombocytopenia occurring in approximately 29.7% of patients, as reported in a recent study 1. This condition, typically caused by the Epstein-Barr virus (EBV), can lead to a decrease in platelets due to the virus's effect on bone marrow production and increased platelet destruction through immune-mediated mechanisms. The key points to consider are:
- Thrombocytopenia is usually mild to moderate, with platelet counts rarely below 50,000/μL, and severe thrombocytopenia (platelets <50 ×10^9/L) is rare, occurring in only 1.5% of patients 1.
- The thrombocytopenia typically resolves on its own as the infection clears, usually within 2-3 weeks, and only 2 cases out of 400 patients required specific therapy 1.
- Patients with thrombocytopenia have distinct clinical and biological features, including a lower frequency of typical mononucleosis symptoms, lower frequency of positive heterophil antibodies, and larger spleen size 1.
- No specific treatment is needed for the low platelets in most cases, but patients should avoid aspirin and NSAIDs, which can affect platelet function, and regular monitoring of blood counts during the acute phase of mono is recommended, especially if the initial platelet count is low.
- In rare cases of severe thrombocytopenia, treatment with intravenous immunoglobulins and corticosteroids may be necessary, as reported in a case study 2.