BRIAN J. MURRAY, M.D.
To the editor: Whittingham and associates (1) report the case of a young woman who developed Sjögren's syndrome with autoimmune sialadenitis about 10 years after an episode of "protracted" infectious mononucleosis. They conclude that the Epstein-Barr virus initiated a break in immunologic tolerance with development of Sjögren's syndrome. However, a causal relation is not necessarily shown and some additional points merit consideration.
Infectious mononucleosis is ubiquitous, and a clinical illness for 4 months is not rare. Nearly 5% of college students at our university health center have the illness for greater than 3 months. The patient's subsequent diarrhea and fatigue,
MURRAY BJ. Sjögren's Syndrome and Infectious Mononucleosis. Ann Intern Med. ;103:161. doi: 10.7326/0003-4819-103-1-161_2
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Published: Ann Intern Med. 1985;103(1):161.
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