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Infectious mononucleosis in children. Evaluation of Epstein-Barr virus-specific serological data
Insights
Pediatric infectious mononucleosis (IM) caused by Epstein-Barr virus (EBV) presents similarly to adult cases. Antibody responses in children with EBV infections are often indistinguishable from those seen in adults.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Immunology
Background:
- Infectious mononucleosis (IM) is a common syndrome in adolescents and young adults.
- Epstein-Barr virus (EBV) is the primary cause of IM.
- Diagnostic challenges can arise in pediatric IM cases.
Purpose of the Study:
- To investigate Epstein-Barr virus (EBV)-specific antibody responses in pediatric patients with signs and symptoms of infectious mononucleosis (IM).
- To compare EBV antibody profiles in children with IM to those in adults.
- To assess the accuracy of diagnostic tests for mononucleosis in pediatric cases.
Main Methods:
- Serological testing for EBV-specific antibodies was performed on 43 pediatric patients.
- Patients presented with symptoms suggestive of IM and had positive Monospot tests.
- Antibody responses were analyzed to determine primary EBV infection, past infection, or absence of infection.
Main Results:
- Thirty out of 43 pediatric patients showed clear serologic evidence of primary EBV infections.
- Thirteen patients had unidentifiable illnesses; 7 lacked EBV antibodies, and 6 had evidence of past EBV infections.
- Initial Monospot test results were found to be false-positive or misinterpreted in 13 patients with unidentifiable illnesses, and in 2 patients with current EBV infections.
Conclusions:
- Classical infectious mononucleosis (IM) occurs in children and is caused by Epstein-Barr virus (EBV).
- EBV-specific antibody responses in pediatric IM cases are comparable to those observed in adult cases.
- Diagnostic accuracy of mononucleosis tests in children requires careful interpretation, especially in cases without clear EBV serology.
Abstract:
Epstein-Barr virus (EBV)-specific antibody responses were determined in 43 consecutive pediatric patients who had signs and symptoms of inectious mononucleosis (IM) and positive diagnostic tests for mononucleosis (Monspot). Thirty patients gave clear-cut serologic evidence of primary EBV infections; of the remaining 13 patients, seven had no antibodies to EBV in the acute- or convalescent-phase sera and six showed serologic patterns of past EBV infections. Further testing proved that the initial Monospot results were either false-positive or were incorrectly interpreted in all 13 patients with unidentifiable illnesses but in only two of the patients with current EBV infections. The data confirm the occurrence of classical IM in children and show that the disease and the EBV-specific antibody responses can be virtually indistinguishable from adult cases.