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[Multivariate analysis of the associations between laboratory data and clinical features among patients with
1Department of Clinical Pathology, Kawasaki Medical School, Kurasiki.
Abstract:
Infectious mononucleosis (IM) syndrome is typically caused by EBV, but also by drugs and other organisms such as CMV and HBV. It demonstrates a wide range of clinical and laboratory characteristics, presumably depending on the age of onset. However, associations of laboratory abnormalities with the clinical features have not been well documented. We evaluated here, the associations among patients with IM syndrome using of multiple regression (MR) and multiple logistic regression (MLR) analyses. We examined 90 (40 males, 50 females) patients, who were admitted to our hospital with IM syndrome. The diagnostic criteria were fever and presence of atypical lymphocytes (> 5% of the WBC or the count including monocytes > 5000/microliter), and at least 3 of 7 clinical features: tonsillitis, lymphadenopathy, skin rash, hepato-, spleno-megaly, hepatic dysfunction. The diagnosis of EBV was serologically confirmed in 41 cases. MR revealed that the higher age group tended to have lower platelet counts, and that lower platelet counts were associated with higher ALT levels. In addition, MLR revealed that patients with skin rash tended not to have splenomegaly. The frequency of splenomegaly was not related to age, contrary to the findings of previous reports. These findings are useful to differentiate IM syndrome based on laboratory data.
Insights
Infectious mononucleosis (IM) syndrome, often caused by Epstein-Barr virus (EBV), shows varied lab results. Higher age correlated with lower platelets, linked to elevated ALT, while skin rash predicted less splenomegaly.
Area of Science:
- Infectious Diseases
- Hematology
- Virology
Context:
- Infectious mononucleosis (IM) syndrome presents with diverse clinical and laboratory features.
- Associations between laboratory abnormalities and clinical manifestations in IM are not well-documented.
- Epstein-Barr virus (EBV) is a common cause of IM, alongside other agents like CMV and HBV.
Purpose:
- To investigate the associations among laboratory abnormalities and clinical features in patients with IM syndrome.
- To utilize multiple regression (MR) and multiple logistic regression (MLR) analyses for evaluating these associations.
- To provide data that aids in differentiating IM syndrome based on laboratory findings.
Summary:
- A study of 90 IM syndrome patients (40 males, 50 females) confirmed EBV in 41 cases.
- MR analysis indicated higher age groups had lower platelet counts, which correlated with higher ALT levels.
- MLR revealed that skin rash presence was associated with a lower likelihood of splenomegaly, and splenomegaly frequency was not age-dependent.
Impact:
- Findings offer insights into the relationship between age, platelet count, ALT levels, and clinical symptoms like skin rash and splenomegaly in IM.
- These associations can assist clinicians in the diagnostic process and differential diagnosis of IM syndrome.
- The study contributes to a better understanding of IM pathophysiology and clinical heterogeneity.