Comparative study of biomarkers for the early identification of Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis in infectious mononucleosis
Abstract Background and aim Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) and infectious mononucleosis (EBV-IM) share mimic symptoms in the early stages of childhood development. We aimed to examine the clinical features and laboratory indices of these two diseases in ch...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08654-6 |
| _version_ | 1797453762801958912 |
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| author | Lisha Cai Yuan Xing Yahong Xia Zihan Zhang Zebin Luo Yongmin Tang Yan Chen Xiaojun Xu |
| author_facet | Lisha Cai Yuan Xing Yahong Xia Zihan Zhang Zebin Luo Yongmin Tang Yan Chen Xiaojun Xu |
| author_sort | Lisha Cai |
| collection | DOAJ |
| description | Abstract Background and aim Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) and infectious mononucleosis (EBV-IM) share mimic symptoms in the early stages of childhood development. We aimed to examine the clinical features and laboratory indices of these two diseases in children and uncover unique indicators to assist pediatricians in identifying these diseases early. Methods We collected clinical data from 791 pediatric patients diagnosed with EBV-IM or EBV-HLH, compared the clinical traits and laboratory biomarkers presented in the two groups, and constructed predictive models based on them. Results Patients with EBV-IM had greater ratios of cervical lymphadenopathy, eyelid edema, and tonsillitis, whereas individuals with EBV-HLH were more likely to have hepatomegaly and splenomegaly. When using the criteria of interleukin (IL)-10 > 89.6 pg/mL, interferon (IFN)-γ > 45.6 pg/mL, ferritin > 429 μg/L, D-dimer > 3.15 mg/L and triglycerides > 2.1 mmol/L, the sensitivity was 87.9%, 90.7%, 98.1%, 91.1% and 81.5% to predict EBV-HLH, while the specificity was 98.4%, 96.3%, 96.5%, 94.1% and 80.6%, respectively. A logistic regression model based on four parameters (IL-10, ferritin, D-dimer, and triglycerides) was established to distinguish EBV-HLH patients from EBV-IM patients, with a sensitivity of 98.0% and a specificity of 98.2%. Conclusions IL-10, IFN-γ, ferritin and D-dimer levels are significantly different between EBV-HLH and EBV-IM. Predictive models based on clinical signs and laboratory findings provide simple tools to distinguish the two situations. |
| first_indexed | 2024-03-09T15:27:33Z |
| format | Article |
| id | doaj.art-b624d315cb0b4ce2b6fe8a57fa0ee316 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-09T15:27:33Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-b624d315cb0b4ce2b6fe8a57fa0ee3162023-11-26T12:27:52ZengBMCBMC Infectious Diseases1471-23342023-10-012311910.1186/s12879-023-08654-6Comparative study of biomarkers for the early identification of Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis in infectious mononucleosisLisha Cai0Yuan Xing1Yahong Xia2Zihan Zhang3Zebin Luo4Yongmin Tang5Yan Chen6Xiaojun Xu7Division of Hematology-Oncology, Children’s Hospital of Zhejiang University School of MedicineDivision of Hematology-Oncology, Children’s Hospital of Zhejiang University School of MedicineDivision of Hematology-Oncology, Children’s Hospital of Zhejiang University School of MedicineDivision of Hematology-Oncology, Children’s Hospital of Zhejiang University School of MedicineDivision of Hematology-Oncology, Children’s Hospital of Zhejiang University School of MedicineDivision of Hematology-Oncology, Children’s Hospital of Zhejiang University School of MedicineDepartment of Pediatrics, The Affiliated Hospital of Zunyi Medical University, Guizhou Children’s HospitalDivision of Hematology-Oncology, Children’s Hospital of Zhejiang University School of MedicineAbstract Background and aim Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) and infectious mononucleosis (EBV-IM) share mimic symptoms in the early stages of childhood development. We aimed to examine the clinical features and laboratory indices of these two diseases in children and uncover unique indicators to assist pediatricians in identifying these diseases early. Methods We collected clinical data from 791 pediatric patients diagnosed with EBV-IM or EBV-HLH, compared the clinical traits and laboratory biomarkers presented in the two groups, and constructed predictive models based on them. Results Patients with EBV-IM had greater ratios of cervical lymphadenopathy, eyelid edema, and tonsillitis, whereas individuals with EBV-HLH were more likely to have hepatomegaly and splenomegaly. When using the criteria of interleukin (IL)-10 > 89.6 pg/mL, interferon (IFN)-γ > 45.6 pg/mL, ferritin > 429 μg/L, D-dimer > 3.15 mg/L and triglycerides > 2.1 mmol/L, the sensitivity was 87.9%, 90.7%, 98.1%, 91.1% and 81.5% to predict EBV-HLH, while the specificity was 98.4%, 96.3%, 96.5%, 94.1% and 80.6%, respectively. A logistic regression model based on four parameters (IL-10, ferritin, D-dimer, and triglycerides) was established to distinguish EBV-HLH patients from EBV-IM patients, with a sensitivity of 98.0% and a specificity of 98.2%. Conclusions IL-10, IFN-γ, ferritin and D-dimer levels are significantly different between EBV-HLH and EBV-IM. Predictive models based on clinical signs and laboratory findings provide simple tools to distinguish the two situations.https://doi.org/10.1186/s12879-023-08654-6Hemophagocytic lymphohistiocytosisInfectious mononucleosisDiagnosisInterleukin-10Interferon-γ |
| spellingShingle | Lisha Cai Yuan Xing Yahong Xia Zihan Zhang Zebin Luo Yongmin Tang Yan Chen Xiaojun Xu Comparative study of biomarkers for the early identification of Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis in infectious mononucleosis BMC Infectious Diseases Hemophagocytic lymphohistiocytosis Infectious mononucleosis Diagnosis Interleukin-10 Interferon-γ |
| title | Comparative study of biomarkers for the early identification of Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis in infectious mononucleosis |
| title_full | Comparative study of biomarkers for the early identification of Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis in infectious mononucleosis |
| title_fullStr | Comparative study of biomarkers for the early identification of Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis in infectious mononucleosis |
| title_full_unstemmed | Comparative study of biomarkers for the early identification of Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis in infectious mononucleosis |
| title_short | Comparative study of biomarkers for the early identification of Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis in infectious mononucleosis |
| title_sort | comparative study of biomarkers for the early identification of epstein barr virus associated hemophagocytic lymphohistiocytosis in infectious mononucleosis |
| topic | Hemophagocytic lymphohistiocytosis Infectious mononucleosis Diagnosis Interleukin-10 Interferon-γ |
| url | https://doi.org/10.1186/s12879-023-08654-6 |
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