将ADA鉴定为儿童非典型爱泼斯坦-巴尔病毒感染的生物标志物。

Identification of ADA as a Biomarker for Atypical Epstein Barr Virus Infection in Children.

作者信息

Shi Ting, Huang Linlin, Zhang Wangsheng, Shi Wenxin, Wu Jiahui, Bian Yuanxi, Jiang Yanqun, Tian Jianmei

机构信息

Department of Infectious Diseases, Soochow University Affiliated Children's Hospital, Suzhou, China.

Pediatric Intensive Care Unit, Soochow University Affiliated Children's Hospital, Suzhou, China.

出版信息

Klin Padiatr. 2023 Jul;235(4):221-227. doi: 10.1055/a-2041-2986. Epub 2023 Apr 28.

DOI:10.1055/a-2041-2986

PMID:37116540

Abstract

OBJECTIVE

This study aims to explore the ability of adenosine deaminase (ADA) to discriminate atypical Epstein Barr virus (EBV) infection in children from acute febrile illness.

METHODS

All children admitted to the Children's Hospital of Soochow University between 2018 and 2019, who were acute febrile patients and subjected to the plasma EBV-DNA polymerase chain reaction (PCR) and indirect immunofluorescence (IIF) assay for EBV-specific antibodies assays. The diagnostic value of each detection index was compared by the area under the ROC curve.

RESULTS

In children with atypical Epstein Barr virus infection, the sensitivity, specificity, positive predictive value, negative predictive value and Youden index were 62.87%, 100.00%,100.00%, 61.73% and 0.63 for EBV-DNA PCR assay, 80.84%, 100.00%, 100.00%, 75.76% and 0.81 for VCA-IgG avidity and 89.22%, 87.00%, 91.98%, 82.86% and 0.76 for ADA. VCA-IgG avidity (AUC=0.904, P<0.01) and ADA (AUC=0.881, P<0.01) assays had the great diagnostic efficiency. In addition, the sensitivity, specificity and AUC were 92.75%,91.43% and 0.921(95%CI: 0.856-0.985) for ADA in the course≤3 days group, respectively.

CONCLUSIONS

ADA has a good diagnostic value in the early stage of atypical EBV infection, and is not affected by primary EBV infection and reactivation. SCHLüSSELWöRTER: Adenosine deaminase, Epstein -Barr virus, Biomarker, children.

摘要

目的

本研究旨在探讨腺苷脱氨酶（ADA）鉴别儿童非典型爱泼斯坦-巴尔病毒（EBV）感染与急性发热性疾病的能力。

方法

选取2018年至2019年期间苏州大学附属儿童医院收治的急性发热患儿，进行血浆EBV-DNA聚合酶链反应（PCR）及EBV特异性抗体的间接免疫荧光（IIF）检测。通过ROC曲线下面积比较各检测指标的诊断价值。

结果

在非典型EBV感染患儿中，EBV-DNA PCR检测的敏感性、特异性、阳性预测值、阴性预测值及约登指数分别为62.87%、100.00%、100.00%、61.73%和0.63；VCA-IgG亲和力检测分别为80.84%、100.00%、100.00%、75.76%和0.81；ADA检测分别为89.22%、87.00%、91.98%、82.86%和0.76。VCA-IgG亲和力检测（AUC=0.904，P<0.01）和ADA检测（AUC=0.881，P<0.01）具有较高的诊断效率。此外，病程≤3天组中ADA的敏感性、特异性及AUC分别为92.75%、91.43%和0.921（95%CI：0.856-0.985）。