Adenosine deaminase as a marker for the severity of infectious mononucleosis secondary to EBV in children
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Updated: Oct 3, 2025
Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis
Published on: September 7, 2022
Ting Shi1, Jungen Li2, Yuzhu Miao2
1Children's Hospital of Soochow University, 303 Jingde Road, Suzhou, 215000, Jiangsu, China.
Insights
Adenosine deaminase may indicate infectious mononucleosis severity in children. This enzyme is a predictor of elevated alanine transaminase, a marker of liver inflammation.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Biochemistry
- Immunology
Background:
- Infectious mononucleosis (IM) is common in children and young adults, sometimes causing liver issues.
- Elevated transaminase levels, indicative of liver inflammation, are frequently observed in IM patients.
- Liver failure is a rare but serious complication of IM.
Purpose of the Study:
- To investigate adenosine deaminase (ADA) as a marker for IM severity in children.
- To determine if ADA levels predict elevated alanine transaminase (ALT) in pediatric IM cases.
Main Methods:
- A case-control study involving 104 children with IM and 50 controls with other infections.
- Categorization of IM patients into those with normal and elevated ALT levels.
- Analysis of clinical and laboratory data, including ADA levels and immune cell markers.
Main Results:
- ADA levels were significantly higher in IM patients compared to controls (P < 0.001).
- ADA levels strongly correlated with lymphocyte counts and specific T and B cell populations.
- ADA demonstrated high sensitivity (97.1%) and specificity (94.0%) for diagnosing IM.
Conclusions:
- Adenosine deaminase shows potential as a marker for IM severity in children.
- ADA may serve as a predictor for elevated ALT levels in pediatric IM patients.
Background:
Infectious mononucleosis, a common disease in children and young adults, is often accompanied by elevated transaminase levels and rarely, liver failure. This study aimed to determine whether adenosine deaminase is a marker of severity in children with infectious mononucleosis, especially those with elevated alanine transaminase levels.
Methods:
This case-control study was conducted at the Children's Hospital of Soochow University. A total of 104 children with infectious mononucleosis and 50 controls with other acute infections and fever, tonsillitis, or lymphadenitis, were enrolled in the study. Among the 104 children with infectious mononucleosis, 54 had normal alanine transaminase levels and 50 had elevated alanine transaminase levels. The children's clinical and laboratory data were analyzed to assess the diagnostic value of adenosine deaminase in the three groups.
Results:
The adenosine deaminase level in the infectious mononucleosis group was significantly higher than that in the control group (P < 0.001). The adenosine deaminase levels were highly correlated with lymphocyte count, CD3+CD8+ T cells (%), CD4+/CD8+ ratio, and CD3-CD19+ (%) (r > 0.7, P < 0.01). The sensitivity and specificity of adenosine deaminase in predicting children with infectious mononucleosis were 97.1% and 94.0%, respectively. Furthermore, multivariate regression analysis revealed that adenosine deaminase level was a risk factor for elevated alanine transaminase in children with infectious mononucleosis.
Conclusions:
Adenosine deaminase may be a marker of the severity of infectious mononucleosis in children, and a predictor of elevated alanine transaminase in children with infectious mononucleosis.
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