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An Efficient and Simple Method to Establish NK and T Cell Lines from Patients with Chronic Active Epstein-Barr Virus Infection
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An Efficient and Simple Method to Establish NK and T Cell Lines from Patients with Chronic Active Epstein-Barr Virus Infection

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Clinical warning of hemophagocytic syndrome caused by Epstein-Barr virus

Jinjin Shi1, Chu Chu1, Min Yu1

  • 1Department of Infectious Disease, Children's Hospital of Soochow University, Suzhou, 215003, China.

Italian Journal of Pediatrics
|January 8, 2021
PubMed

Insights

In young children, Epstein-Barr virus (EBV) can cause infectious mononucleosis (IM) or hemophagocytic lymphohistiocytosis (HLH). D-dimer levels show promise as a prognostic indicator for EBV-HLH.

Area of Science:

  • Pediatric Infectious Diseases
  • Hematology
  • Immunology

Background:

  • Epstein-Barr virus (EBV) infection is common in children.
  • In some cases, EBV can lead to severe conditions like infectious mononucleosis (IM) and hemophagocytic lymphohistiocytosis (HLH).
  • Differentiating between EBV-IM and EBV-HLH is crucial for appropriate management.

Purpose of the Study:

  • To compare clinical and laboratory features of EBV-IM and EBV-HLH in young children (1-3 years old).
  • To identify potential risk factors for EBV-HLH.
  • To evaluate the prognostic value of D-dimer in EBV-HLH.

Main Methods:

  • Retrospective analysis of clinical data from 92 children with EBV infection (2011-2019).
  • Comparison of clinical manifestations and laboratory test results between EBV-IM (61 cases) and EBV-HLH (31 cases) groups.
  • Correlation analysis between plasma EBV DNA load and various laboratory markers.

Main Results:

  • EBV-HLH patients exhibited prolonged fever, higher rates of hepatomegaly, and elevated levels of ALT, AST, LDH, TG, SF, D-Dimer, and EBV DNA compared to EBV-IM patients.
  • EBV-HLH patients showed significantly lower absolute counts of CD3+, CD4+, CD8+, NK, and CD3-CD19+ cells, as well as lower IgA and IgM levels.
  • Plasma EBV DNA load correlated positively with several inflammatory markers in EBV-HLH and with D-dimer in EBV-IM. D-dimer demonstrated high sensitivity (88.9%) and specificity (90.2%) for EBV-HLH.

Conclusions:

  • Prolonged fever, hepatomegaly, specific laboratory abnormalities, and immune cell count changes differentiate EBV-HLH from EBV-IM in young children.
  • Elevated D-dimer levels may serve as a valuable prognostic indicator for EBV-HLH.
Abstract

Keywords:
D-dimerEBV DNA loadHemophagocytic syndromeInfectious mononucleosis

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