Department of Clinical Laboratory, The Second Affiliated Hospital of Anhui Medical University, Anhui, China.
Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
Int J Lab Hematol. 2023 Dec;45(6):890-898. doi: 10.1111/ijlh.14131. Epub 2023 Jul 27.
Infectious mononucleosis (IM) is a common infectious disease in children mainly caused by Epstein-Barr virus (EBV) infection, followed by abnormal immune response, and resulting in serious complications. However, there are few clinical analyses of immune responses in children with IM at different stages.
This study combined EBV serological test and EBV DNA test to diagnose the infection status of children with IM, and the infection status was divided into primary acute IM infection (AIM), primary late IM infection (LIM) and reactivation IM infection (RIM).
The results revealed that the absolute numbers of leukocytes and CD8 T lymphocytes in primary IM infection were significantly higher than those in reactivation infection, while the frequencies of CD4 T lymphocytes and B cells were significantly lower than those in reactivation infection. In addition, the activities of ALT, AST, α-HBDH and LDH in liver function indicators in primary infection were significantly increased compared with reactivation infection. Similarly, the EBV DNA levels of the primary infection were significantly higher than that of the reactivation infection.
There are differences in immune response at different stages of infection, which can provide guidance for effective treatment in children with IM infection.
传染性单核细胞增多症（IM）是儿童期常见的传染病，主要由 EBV 感染引起，随后出现异常免疫反应，导致严重并发症。然而，对于不同阶段儿童的 IM 免疫反应，临床分析较少。
本研究结合 EBV 血清学检测和 EBV DNA 检测，诊断儿童 IM 的感染状态，将感染状态分为原发性急性 IM 感染（AIM）、原发性晚期 IM 感染（LIM）和再激活 IM 感染（RIM）。
结果表明，原发性 IM 感染时白细胞和 CD8 T 淋巴细胞绝对值明显高于再激活感染，而 CD4 T 淋巴细胞和 B 细胞的频率明显低于再激活感染。此外，原发性感染时肝功能指标 ALT、AST、α-HBDH 和 LDH 的活性明显高于再激活感染。同样，原发性感染时 EBV DNA 水平明显高于再激活感染。
在感染的不同阶段存在免疫反应的差异，可为儿童 IM 感染的有效治疗提供指导。
