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World Journal of Pediatrics

, Volume 7, Issue 1, pp 45–49 | Cite as

Epidemiologic and clinical characteristics of infectious mononucleosis associated with Epstein-Barr virus infection in children in Beijing, China

  • Li-Wei Gao
  • Zheng-De Xie
  • Ya-Yi Liu
  • Yan Wang
  • Kun-Ling ShenEmail author
Original Article

Abstract

Background

Infectious mononucleosis (IM) is a self-limited disease, but a few cases may have severe complications. This retrospective study was to explore the epidemiologic and clinical characteristics of IM associated with Epstein-Barr virus infection (EBV-IM) in children.

Methods

Hospitalized patients with EBV-IM were enrolled during January 2005 to October 2008 in Beijing Children’s Hospital Affi liated to Capital Medical University. All patients were divided into four groups: <1 year (group I), 1 to 3 years (group II), 3 to 6 years (group III), and ≥6 years (group IV). The epidemiology and clinical characteristics were compared among the four groups.

Results

Totally 418 patients were enrolled, with 245 boys and 173 girls. Fever, lymphadenopathy and pharyngitis were three main manifestations of the patients. The incidences of hepatomegaly, splenomegaly and rash were higher in the patients aged below 6 years, and with age increment the incidences lowered. In contrast, the patients aged <1 year had the lowest incidence of tonsillopharyngitis. The total white blood cell count was higher in the infantile group than in the other groups (P=0.038). The infantile group had significantly lower levels of serum alanine aminotransferase and aspartate aminotransferase than the older groups (P=0.007 and P=0.012 respectively). The percentage of CD4+ T cell subset decreased and the percentage of CD8+ T cell subset increased with age increment.

Conclusions

The incidence of EBV-IM peaked in children at age of 4 to 6 years in Northern China. Most of the patients had the classic triad of fever, lymphadenopathy and pharyngitis. Clinical symptoms, signs, laboratory findings and complications of patients varied with ages.

Key words

children Epstein-Barr virus infectious mononucleosis 

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References

  1. 1.
    Cohen JI. Epstein-Barr virus infection. N Engl J Med 2000;343:481–492.CrossRefPubMedGoogle Scholar
  2. 2.
    Hallee TJ, Evans AS, Niederman JC, Brooks CM, Voegtly H. Infectious mononucleosis at the United States Military Academy. A prospective study of a single class over four years. Yale J Biol Med 1974;47:182–195.PubMedGoogle Scholar
  3. 3.
    Kangro HO, Osman HK, Lau YL, Heath RB, Yeung CY, Ng MH. Seroprevalence of antibodies to human herpesviruses in England and Hong Kong. J Med Virol 1994;43:91–96.CrossRefPubMedGoogle Scholar
  4. 4.
    Chan CW, Chiang AK, Chan KH, Lau AS. Epstein-Barr virusassociated infectious mononucleosis in Chinese children. Pediatr Infect Dis J 2003;22:974–978.CrossRefPubMedGoogle Scholar
  5. 5.
    Tsai MH, Hsu CY, Yen MH, Yan DC, Chiu CH, Huang YC, et al. Epstein-Barr virus-associated infectious mononucleosis and risk factor analysis for complications in hospitalized children. J Microbiol Immunol Infect 2005;38:255–261.PubMedGoogle Scholar
  6. 6.
    Henter JI, Horne A, Aricó M, Egeler RM, Filipovich AH, Imashuku S, et al. HLH-2004: diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer 2007;48:124–131.CrossRefPubMedGoogle Scholar
  7. 7.
    Moffat LE. Infectious mononucleosis. Prim Care Update Ob Gyns 2001;8:73–77.CrossRefPubMedGoogle Scholar
  8. 8.
    Papesch M, Watkins R. Epstein-Barr virus infectious mononucleosis. Clin Otolaryngol Allied Sci 2001;26:3–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Williams H, Crawford DH. Epstein-Barr virus: the impact of scientific advances on clinical practice. Blood 2006;107:862–864.CrossRefPubMedGoogle Scholar
  10. 10.
    Balfour HH Jr, Holman CJ, Hokanson KM, Lelonek MM, Giesbrecht JE, White DR, et al. A prospective clinical study of Epstein-Barr virus and host interactions during acute infectious mononucleosis. J Infect Dis 2005;192:1505–1512.CrossRefPubMedGoogle Scholar
  11. 11.
    Cheng CC, Chang LY, Shao PL, Lee PI, Chen JM, Lu CY, et al. Clinical manifestations and quantitative analysis of virus load in Taiwanese children with Epstein-Barr virus-associated infectious mononucleosis. J Microbiol Immunol Infect 2007;40:216–221.PubMedGoogle Scholar
  12. 12.
    Hu L, Yang J, Cui T, Xing H, Cai P. Diagnosis of infectious mononucleosis by combined detection of atypical lymphocytes and transaminase. J Huazhong Univ Sci Technolog Med Sci 2006;26:384–385.CrossRefPubMedGoogle Scholar
  13. 13.
    Doğan I, Ergün M, Cindoruk M, Unal S. Acute hepatitis induced by Epstein-Barr virus infection: a case report. Turk J Gastroenterol 2007;18:119–121.PubMedGoogle Scholar
  14. 14.
    Celtik C, Kucukugu Y, Balci DB, Oner N, Duran R, Karasalihoglu S. Evaluation of clinical and laboratory features of Epstein-Barr virus-associated acute infectious mononucleosis in children. Trakay Univ Tip Fak Derg 2008;25:221–227.Google Scholar
  15. 15.
    Ishikawa T, Zhu BL, Li DR, Zhao D, Maeda H. Epstein-Barr virus myocarditis as a cause of sudden death: two autopsy cases. Int J Legal Med 2005;119:231–235.CrossRefPubMedGoogle Scholar
  16. 16.
    Williams H, Macsween K, McAulay K, Higgins C, Harrison N, Swerdlow A, et al. Analysis of immune activation and clinical events in acute infectious mononucleosis. J Infect Dis 2004;190:63–71.CrossRefPubMedGoogle Scholar
  17. 17.
    Jenson HB. Acute complications of Epstein-Barr virus infectious mononucleosis. Curr Opin Pediatr 2000;12:263–268.CrossRefPubMedGoogle Scholar
  18. 18.
    Zhao F, Peng H, Zeng B. Clinical analysis of infectious mononucleosis children with different ages. Clin J General Pract 2008;6:1133–1134.Google Scholar
  19. 19.
    Grotto I, Mimouni D, Huerta M, Mimouni M, Cohen D, Robin G, et al. Clinical and laboratory presentation of EBV positive infectious mononucleosis in young adults. Epidemiol Infect 2003;131:683–689.CrossRefPubMedGoogle Scholar

Copyright information

© Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Li-Wei Gao
    • 1
  • Zheng-De Xie
    • 2
  • Ya-Yi Liu
    • 2
  • Yan Wang
    • 2
  • Kun-Ling Shen
    • 1
    Email author
  1. 1.Department of Pulmonary and Infectious DiseasesBeijing Children’s Hospital affiliated to Capital Medical UniversityBeijingChina
  2. 2.Department of Virology LaboratoryBeijing Children’s Hospital affiliated to Capital Medical UniversityBeijingChina

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