{
  "abstract": "Objective Infectious mononucleosis (IM) is most commonly caused by Epstein-Barr virus (EBV). However, recent epidemiological shifts have increased the proportion of adult cases attributable to cytomegalovirus (CMV). Early distinction of EBV-related IM (EBV-IM) using routine laboratory parameters may reduce unnecessary testing and facilitate timely counseling regarding activity restriction. This study aimed to identify the laboratory features that distinguish EBV-IM from non-EBV IM and to develop a simple diagnostic scoring system. Methods We retrospectively analyzed 39 consecutive patients with IM (EBV-IM, n = 22; non-EBV IM, n = 17, including CMV-IM, n =8). The laboratory parameters and inflammatory indices were compared between the groups, and receiver operating characteristic curve analyses were used to determine the optimal cutoff values for score development. Results EBV-IM patients had higher alanine aminotransferase (ALT) and alkaline phosphatase (ALP) levels than non-EBV IM patients, whereas the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels were lower in EBV-IM patients. Four variables were used for scoring: ALT ≥ 120 U/L, ALP ≥ 200 U/L, NLR ≤ 0.6, and CRP ≤ 2.0 mg/dL, collectively termed the EBV-IM Laboratory Score (EL-Score). A score ≥ 2 predicted EBV-IM with an area under the curve of 0.95 (95% confidence interval: 0.88-1.00), a sensitivity of 0.91, and a specificity of 0.94. Conclusions The EL-Score, based on routinely available laboratory parameters, may enable the early distinction between EBV-IM and non-EBV IM in internal medicine practice.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "Erina Noguchi"
    },
    {
      "name": "Takashi Ogasawara"
    },
    {
      "name": "Yuki Hiraoka"
    },
    {
      "name": "Koji Nagayama"
    },
    {
      "name": "Hiroaki Takatori"
    },
    {
      "name": "Kazuyuki Shigeno"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/abjz0ptppddyh.bib",
  "cited_by": 0,
  "doi": "10.2169/internalmedicine.7450-26",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7450-26/_article",
  "id": "abjz0ptppddyh",
  "issns": [
    "1349-7235",
    "0918-2918"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7450-26/_article",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/general"
    ],
    [
      "openalex",
      "2730|Viral-associated cancers and disorders"
    ]
  ],
  "openalex": "W7167979923",
  "pdf_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7450-26/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-07-11",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/abjz0ptppddyh.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "10.2169/internalmedicine.7450-26",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7450-26/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Viral-associated cancers and disorders",
      "subfield": "oncology"
    }
  ],
  "title": "Development of a Simple Scoring System to Distinguish Epstein-Barr virus-related Infectious Mononucleosis (EBV-IM) from Non-EBV IM Using Routine Laboratory Parameters",
  "title_text": "Development of a Simple Scoring System to Distinguish Epstein-Barr virus-related Infectious Mononucleosis (EBV-IM) from Non-EBV IM Using Routine Laboratory Parameters",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:31Z",
  "url": "https://research.draconitic.com/paper/abjz0ptppddyh",
  "venue": "Internal Medicine",
  "versions": []
}