Altern Ther Health Med. 2024 May;30(5):148-154.
Epstein-Barr virus (EBV) is a common virus that infects a large portion of the world's population, with most people becoming infected during childhood or adolescence. The objective of this article is to analyze the clinical and laboratory examination results of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children, summarize its characteristics, identify critically ill children as soon as possible, and provide a basis for diagnosis and treatment.
The retrospective analysis in this study involved collecting data from 34 cases of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) admitted to Hebei Children's Hospital from January 2019 to December 2022. The inclusion criteria for the cases studied likely included confirmed diagnosis of EBV-HLH based on clinical symptoms, laboratory findings, and possibly viral testing results. Key parameters analyzed in the study may have included clinical manifestations, laboratory test results (e.g., levels of lactate dehydrogenase, sCD25, IL-10, calcium ions, glutathione aminotransferase, ferritin, alanine aminotransferase, D-dimer), survival rates, and other relevant indicators. Additionally, the cases were likely divided into high-risk groups (with multiple organ dysfunction or requiring ventilator-assisted ventilation) and non-risk groups for comparative analysis.
The results showed that 34 cases (100%) of EBV-HLH had elevated levels of lactate dehydrogenase, sCD25, IL-10, and decreased levels of calcium ions. 97.1% of the children had a fever and elevated levels of glutathione aminotransferase and ferritin, with an 8-week survival rate of 91.2%. The levels of alanine aminotransferase, alanine aminotransferase, lactate dehydrogenase, ferritin, D-dimer, and sCD25 in critically ill children were significantly higher than those in the non-critically ill group, with statistical significance (P < .05). The decreased levels of calcium ions in EBV-HLH patients suggest potential tissue damage and disruption of calcium homeostasis, contributing to the systemic manifestations of the disease. Compared with non-critical recombinant albumin, the decrease in critical recombinant albumin was statistically significant (P < .05).
Significant changes in laboratory results can contribute to the early diagnosis and targeted treatment of EBV-HLH, especially for critically ill children. We should pay timely attention to laboratory examinations, diagnosis and treatment, and avoid or reduce the occurrence of adverse consequences. Based on the results of the study on Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children, specific strategies and criteria can be proposed to aid in the early identification of critically ill children with this condition in clinical practice: Clinical Screening, Risk Stratification, Early Intervention, Multidisciplinary Management and Educational Measures.
EB 病毒（EBV）是一种常见病毒，感染了世界上很大一部分人口，大多数人在儿童或青少年时期感染。本文的目的是分析儿童 EB 病毒相关性噬血细胞性淋巴组织细胞增生症（EBV-HLH）的临床和实验室检查结果，总结其特征，尽快识别危重症患儿，为诊断和治疗提供依据。
本研究采用回顾性分析方法，收集 2019 年 1 月至 2022 年 12 月河北儿童医院收治的 34 例 EB 病毒相关性噬血细胞性淋巴组织细胞增生症（EBV-HLH）患儿的临床资料。本研究病例的纳入标准可能包括基于临床症状、实验室发现和病毒检测结果确诊 EBV-HLH。研究中可能分析的关键参数包括临床表现、实验室检查结果（如乳酸脱氢酶、sCD25、IL-10、钙离子、谷胱甘肽氨基转移酶、铁蛋白、丙氨酸氨基转移酶、D-二聚体）、生存率等其他相关指标。此外，可能将病例分为高危组（多器官功能障碍或需要呼吸机辅助通气）和非高危组进行比较分析。
结果显示，34 例 EBV-HLH 患儿（100%）乳酸脱氢酶、sCD25、IL-10 水平升高，钙离子水平降低。97.1%的患儿发热，谷胱甘肽氨基转移酶和铁蛋白升高，8 周生存率为 91.2%。危重症患儿丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、乳酸脱氢酶、铁蛋白、D-二聚体、sCD25 水平明显高于非危重症组，差异有统计学意义（P<0.05）。EBV-HLH 患儿钙离子水平降低提示可能存在组织损伤和钙稳态紊乱，导致全身表现。与非危重组白蛋白相比，危重组白蛋白的降低具有统计学意义（P<0.05）。
实验室结果的显著变化有助于 EBV-HLH 的早期诊断和靶向治疗，特别是对危重症患儿。我们应及时关注实验室检查、诊断和治疗，避免或减少不良后果的发生。基于对儿童 EB 病毒相关性噬血细胞性淋巴组织细胞增生症（EBV-HLH）的研究结果，可以提出具体的策略和标准，以帮助临床实践中早期识别此类疾病的危重症患儿：临床筛查、风险分层、早期干预、多学科管理和教育措施。
