Infectious mononucleosis, commonly known as mono, is a viral infection often caused by the Epstein-Barr virus (EBV). This condition can lead to various common symptoms, including fatigue, sore throat, and swollen lymph nodes. Liver enzymes, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are proteins released into the bloodstream when liver cells are damaged or inflamed. These enzymes are indicators of liver health. Mono can affect the liver, leading to elevated levels of these enzymes.
Mono’s Impact on the Liver
The Epstein-Barr virus can infect liver cells, triggering an immune response that results in inflammation, known as hepatitis. This inflammation causes liver cells to release enzymes into the bloodstream, leading to elevated levels. This elevation of liver enzymes is common in individuals with mono, affecting approximately 80-90% of patients.
Liver enzyme levels can rise to 2-5 times the normal range, and occasionally even 10-20 times in more severe instances. However, the condition is typically mild and self-limiting, and serious liver damage is rare. The elevated enzymes usually peak during the second or third week of the illness.
Recognizing Liver Involvement
When the liver is affected by mono, individuals might experience symptoms such as fatigue, nausea, loss of appetite, and sometimes mild jaundice (yellowing of the skin and eyes). Dark urine and light-colored stools can also indicate liver involvement. However, these symptoms are often subtle or may not be present, meaning elevated liver enzymes are frequently discovered incidentally during routine blood tests.
Elevated liver enzymes are diagnosed through blood tests, specifically liver function tests (LFTs). A diagnosis of mono is confirmed through blood tests, such as the monospot test or EBV antibody tests, which detect antibodies against the Epstein-Barr virus.
Managing Elevated Liver Enzymes
Elevated liver enzymes associated with mono typically do not require specific treatment, as they usually resolve on their own as the infection clears. Supportive care is the primary approach, focusing on helping the body recover. This includes adequate rest and proper hydration.
Patients are generally advised to avoid alcohol and certain medications that could further stress the liver, such as acetaminophen, especially if liver function is significantly impaired. This should always be done under medical guidance. Liver enzyme levels usually return to normal within 3-6 weeks, though some may take up to 8 weeks or occasionally longer. It is important to seek medical attention if symptoms worsen, such as severe jaundice, intense abdominal pain, persistent vomiting, or confusion. Follow up with a healthcare provider to monitor enzyme levels if they were initially significantly elevated.