Infectious mononucleosis in children and differences in biomarker levels and other features between disease caused by Epstein–Barr virus and other pathogens: a single-center retrospective study in China
Yangcan Ming,
Shengnan Cheng,
Zhixin Chen,
Wen Su,
Shuangyan Lu,
Na Wang,
Huifu Xu,
Lizhe Zhang,
Jing Yu,
Jianqiao Tang
Affiliations
Yangcan Ming
Department of Pediatrics, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology; Wuhan No. 1 Hospital, Wuhan, China
Shengnan Cheng
Department of Ophthalmology, Wuhan Hospital of Traditional Chinese and Western Medicine, Tongji Medical College, Huazhong University of Science and Technology; Wuhan No. 1 Hospital, Wuhan, China
Zhixin Chen
Department of Pediatrics, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology; Wuhan No. 1 Hospital, Wuhan, China
Wen Su
Department of Pediatrics, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology; Wuhan No. 1 Hospital, Wuhan, China
Shuangyan Lu
Department of Blood Transfusion, Wuhan Hospital of Traditional Chinese and Western Medicine, Tongji Medical College, Huazhong University of Science and Technology; Wuhan No. 1 Hospital, Wuhan, China
Na Wang
Department of Pediatrics, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology; Wuhan No. 1 Hospital, Wuhan, China
Huifu Xu
Department of Pediatrics, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology; Wuhan No. 1 Hospital, Wuhan, China
Lizhe Zhang
Department of Integrated Chinese and Western Medicine, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Jing Yu
Department of Blood Transfusion, Wuhan Hospital of Traditional Chinese and Western Medicine, Tongji Medical College, Huazhong University of Science and Technology; Wuhan No. 1 Hospital, Wuhan, China
Jianqiao Tang
Department of Integrated Chinese and Western Medicine, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Background Infectious mononucleosis (IM) is a common viral infection that typically presents with fever, pharyngitis and cervical lymphadenopathy. Our aim was to identify the different pathogens causing IM in children admitted to our hospital and to analyze the differences in features of infection with different organisms. Methods We retrospectively analyzed the data of children aged 0–17 years admitted to Wuhan Children’s Hospital during 2013–2022 with IM. We compared symptoms, physical findings, blood counts, and serum biomarkers between patients with IM due to Epstein–Barr virus (EBV) and IM due to other pathogens. Results Among 1480 enrolled children, 1253 (84.66%) had EBV infection, 806 (54.46%) had M. pneumoniae infection, 796 (53.78%) had cytomegalovirus infection, 159 (10.74%) had parvovirus infection, 38 (2.57%) had influenza virus infection, and 25 (1.69%) had adenovirus infection. Receiver operating characteristic curves were used to determine the area under the curve for alanine transaminase (ALT), aspartate transaminase (AST), Alkaline phosphatase (ALP), total bilirubin (TBil), indirect bilirubin (IBil) levels to assess liver damage, and for creatine kinase (CK), CK-MB, and lactate dehydrogenase (LDH) levels to assess myocardial damage. The optimal cutoff values of these biomarkers were then determined. In multivariate analysis, elevated ALT, AST, ALP, TBil, and IBil were independently associated with liver damage, and age <3 years, CK, CK-MB, and LDH with myocardial damage. Conclusion Evaluation of biomarkers and pathogen detection may help physicians to take preventive actions to avoid serious complications in children with infectious mononucleosis.
