Li Zhong-yue, Lou Jin-gan, Chen Jie
Department of Gastroenterology, Affiliated Children's Hospital, Medical College, Zhejiang University, Hangzhou 310003, China.
Zhonghua Er Ke Za Zhi. 2004 Jan;42(1):20-2.
To improve the clinical diagnostic standard and explore the mechanism of multiple clinical manifestation of Epstein-Barr virus (EBV) infection by studying the primary symptom and related disease spectrum in EBV infected children.
The primary symptom, disease spectrum and prognosis of 190 EBV infected children whose serum EBV-VCA-IgM was positive detected by enzyme-linked immunosorbent assay (ELISA) were retrospectively reviewed.
The primary symptoms of EBV infection were diverse, the most common primary symptom was fever (66.8%), and followed by cough (14.2%), skin eruption (7.9%), lymphadenopathy (5.3%), eyelid edema (3.2%), pharyngalgia (1.6%), cardiac arrhythmia (1.6%), convulsion (1.6%), arthralgia (1.0%), gross hematuria (0.5%), etc. Most systems and organs were involved in the disease, including liver, spleen, lymph nodes, kidney, heart, lung, bone marrow, brain etc., which made the disease spectrum diverse. The most common disease caused by EBV infection was respiratory tract infection (40.5%), followed by infectious mononucleosis (17.9%), Kawasaki disease (6.3%), idiopathic thrombocytopenic purpura (5.8%), viral myocarditis (2.6%), viral encephalitis (2.6%), hemophagocytic syndrome (1.6%), rheumatoid arthritis (1.0%), acute lymphadenitis (1.0%), facial neuritis (1.0%), Evans syndrome (0.5%), systemic lupus erythematosus (0.5%), subacute necrotizing lymphadenitis (0.5%), non-Hodgkin's lymphoma (0.5%), acute aplastic anemia (0.5%), infantile hepatitis syndrome (0.5%), etc.; 9.5% of patients were ultimately diagnosed as EBV infection after long-term fever, and 10% of patients suffered from mixed infection. The prognosis of EBV infection was different due to involvement of different systems and organs. One patient died of hemophagocytic syndrome.
The systems and organs impaired by EBV infection in children were diverse, and almost all the systems and organs were involved. Pediatricians should comprehensively analyze the clinical data and order corresponding laboratory examinations early to make the correct diagnosis and reduce the misdiagnosis rate and to treat appropriately.
通过研究EB病毒(EBV)感染儿童的首发症状及相关疾病谱,提高临床诊断水平,探讨EBV感染多种临床表现的机制。
回顾性分析190例酶联免疫吸附试验(ELISA)检测血清EBV-VCA-IgM阳性的EBV感染儿童的首发症状、疾病谱及预后。
EBV感染的首发症状多样,最常见的首发症状是发热(66.8%),其次是咳嗽(14.2%)、皮疹(7.9%)、淋巴结肿大(5.3%)、眼睑水肿(3.2%)、咽痛(1.6%)、心律失常(1.6%)、惊厥(1.6%)、关节痛(1.0%)、肉眼血尿(0.5%)等。疾病累及多个系统和器官,包括肝、脾、淋巴结、肾、心、肺、骨髓、脑等,导致疾病谱多样。EBV感染最常见的疾病是呼吸道感染(40.5%),其次是传染性单核细胞增多症(17.9%)、川崎病(6.3%)、特发性血小板减少性紫癜(5.8%)、病毒性心肌炎(2.6%)、病毒性脑炎(2.6%)、噬血细胞综合征(1.6%)、类风湿关节炎(1.0%)、急性淋巴结炎(1.0%)、面神经炎(1.0%)、伊文氏综合征(0.5%)、系统性红斑狼疮(0.5%)、亚急性坏死性淋巴结炎(0.5%)、非霍奇金淋巴瘤(0.5%)、急性再生障碍性贫血(0.5%)、婴儿肝炎综合征(0.5%)等;9.5%的患者长期发热后最终诊断为EBV感染,10%的患者存在混合感染。EBV感染因累及不同系统和器官,预后不同。1例患者死于噬血细胞综合征。
儿童EBV感染所致系统和器官损害多样,几乎累及所有系统和器官。儿科医生应综合分析临床资料,早期进行相应实验室检查,以做出正确诊断,降低误诊率,并进行恰当治疗。