Kato T, Ichihara K, Terada K, Matsuda N
Department of Clinical Pathology, Kawasaki Medical School, Kurasiki.
Rinsho Byori. 1998 Oct;46(10):1056-60.
Infectious mononucleosis (IM) syndrome is typically caused by EBV, but also by drugs and other organisms such as CMV and HBV. It demonstrates a wide range of clinical and laboratory characteristics, presumably depending on the age of onset. However, associations of laboratory abnormalities with the clinical features have not been well documented. We evaluated here, the associations among patients with IM syndrome using of multiple regression (MR) and multiple logistic regression (MLR) analyses. We examined 90 (40 males, 50 females) patients, who were admitted to our hospital with IM syndrome. The diagnostic criteria were fever and presence of atypical lymphocytes (> 5% of the WBC or the count including monocytes > 5000/microliter), and at least 3 of 7 clinical features: tonsillitis, lymphadenopathy, skin rash, hepato-, spleno-megaly, hepatic dysfunction. The diagnosis of EBV was serologically confirmed in 41 cases. MR revealed that the higher age group tended to have lower platelet counts, and that lower platelet counts were associated with higher ALT levels. In addition, MLR revealed that patients with skin rash tended not to have splenomegaly. The frequency of splenomegaly was not related to age, contrary to the findings of previous reports. These findings are useful to differentiate IM syndrome based on laboratory data.
传染性单核细胞增多症(IM)综合征通常由EB病毒引起,但也可由药物及其他生物体如巨细胞病毒和乙肝病毒引起。它表现出广泛的临床和实验室特征,可能取决于发病年龄。然而,实验室异常与临床特征之间的关联尚未得到充分记录。我们在此使用多元回归(MR)和多元逻辑回归(MLR)分析评估了IM综合征患者之间的关联。我们检查了90例(40例男性,50例女性)因IM综合征入住我院的患者。诊断标准为发热且存在异型淋巴细胞(>白细胞的5%或包括单核细胞在内的计数>5000/微升),以及7项临床特征中的至少3项:扁桃体炎、淋巴结病、皮疹、肝脾肿大、肝功能障碍。41例患者经血清学确诊为EB病毒感染。MR显示年龄较大的组往往血小板计数较低,且血小板计数较低与较高的谷丙转氨酶水平相关。此外,MLR显示有皮疹的患者往往没有脾肿大。与先前报告的结果相反,脾肿大的频率与年龄无关。这些发现有助于根据实验室数据鉴别IM综合征。