From the Research
There is no clear evidence that steroids increase the risk of lymphoma in patients with mononucleosis. The use of corticosteroids in patients with infectious mononucleosis has been a topic of debate, with some studies suggesting potential benefits in reducing symptom severity, particularly in cases with significant throat inflammation or airway compromise.
- Corticosteroids like prednisone are sometimes used in severe cases of infectious mononucleosis to reduce throat inflammation and airway obstruction, typically at doses of 40-60mg daily for 5-7 days with a taper.
- A recent study published in 2025 1 found that the use of systemic corticosteroids during EBV-induced infectious mononucleosis is generally safe, at least with concomitant antibiotic therapy, and did not find an increased risk of lymphoma.
- While steroids can temporarily suppress immune function, short courses for mononucleosis treatment have not been linked to increased lymphoma development, as supported by a study from 2015 2.
- Mononucleosis itself, caused by Epstein-Barr virus (EBV), carries a small inherent risk for certain lymphomas due to the virus's ability to infect B lymphocytes and potentially contribute to malignant transformation in rare cases, as noted in a study from 2023 3.
- However, this risk exists regardless of steroid use, and the benefits of steroids in managing severe symptoms like significant tonsillar enlargement with airway compromise generally outweigh theoretical concerns about lymphoma risk.
- Patients with mononucleosis should be monitored for complications regardless of whether steroids are used in their treatment, as suggested by a study from 2005 4 and another from 1996 5.