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Related Experiment Video

Updated: Jul 14, 2026

Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis
08:44

Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis

Published on: September 7, 2022

Development of a Simple Scoring System to Distinguish Epstein-Barr virus-related Infectious Mononucleosis (EBV-IM)

Erina Noguchi1,2, Takashi Ogasawara1,3, Yuki Hiraoka3

  • 1Department of General Internal Medicine, Hamamatsu Medical Center, Japan.

Internal Medicine (Tokyo, Japan)
|July 12, 2026
PubMed
Summary

A new EL-Score using routine lab tests can help distinguish Epstein-Barr virus (EBV)-induced infectious mononucleosis (IM) from other causes like cytomegalovirus (CMV). This score aids early diagnosis in internal medicine practice.

Keywords:
C-reactive proteinEpstein-Barr virusNeutrophil-to-lymphocyte ratioalanine aminotransferasealkaline phosphataseinfectious mononucleosis

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Area of Science:

  • Internal Medicine
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Infectious mononucleosis (IM) is often caused by Epstein-Barr virus (EBV), but cytomegalovirus (CMV) is an increasing cause in adults.
  • Early differentiation between EBV-IM and non-EBV IM is crucial for appropriate patient management and counseling.

Purpose of the Study:

  • To identify laboratory markers that differentiate EBV-IM from non-EBV IM.
  • To develop a simple diagnostic scoring system for early EBV-IM detection.

Main Methods:

  • Retrospective analysis of 39 IM patients (22 EBV-IM, 17 non-EBV IM).
  • Comparison of laboratory parameters including ALT, ALP, NLR, and CRP.
  • Development of the EBV-IM Laboratory Score (EL-Score) using ROC curve analysis.

Main Results:

  • EBV-IM patients showed higher ALT and ALP levels.
  • EBV-IM patients had lower NLR and CRP levels compared to non-EBV IM.
  • The EL-Score (ALT ≥ 120 U/L, ALP ≥ 200 U/L, NLR ≤ 0.6, CRP ≤ 2.0 mg/dL) achieved high accuracy (AUC 0.95) in predicting EBV-IM.

Conclusions:

  • The EL-Score effectively distinguishes EBV-IM from non-EBV IM using readily available lab results.
  • This scoring system can support early diagnosis and management decisions in internal medicine settings.