Clinical Characteristics Of Infectious Mononucleosis In Children

Objective:Infectious mononucleosis (infectious mononucleosis, IM) is an acute infectious diseases caused by Epstein-Barr (EB) virus, and it is more common in children period. The clinical presentation is characterized by fever, angina and lymphadenitis, also can damage other vital organs, the most frequent in liver damage. Laboratory checks visible alanine amino transferees (ALT) increase, abdominal color dopplar ultrasound and liver enlargement. In this paper, we analyzed the clinical characteristics in different age of the children with infectious mononucleosis admitted to our hospital. Explore the characteristics of the clinical and liver damage in different age paragraph children with IM, in order to improve the diagnosis of the disease and the early detection of liver damage, facilitate early treatment, rate of prevention and control complications.Methods:Seventy three hospitalized patients with EBV-IM were enrolled from Aug. 2003 to Jan. 2011 in our pediatric. All patients were divided into 2 groups as younger than 6 years old group (groupⅠ) and more than or equal to 6 years old group (groupⅡ). These children include 46 boy cases and 27 girl cases. The clinical symptoms, signs, laboratory examinations and the incidence of complications between 2 groups were compared. Clinical view of the main indicators include the occurrence of time, age, clinical symptoms and signs and laboratory to check and blood disguise commandeer a week and lymphocytes are destroyed and Liver biochemical, CD₄,CD₈,EBV-CA-IgM and liver and spleen on the superResults:Both 73 patients were enrolled, with 46 boys and 27 girls, and the median age was 4.5 years old. Patients in groupⅠaccounted for 61.64%, and in groupⅡ accounted for 38.36%. The pathogenesis of peak age concentrated in 4, 6 years old, incidence with 1 - March and 10 - December for the highest peak of the disease.Fever, lymphadenitis and pharyngitis were main manifestations of the patients with EBV-IM, these incidence rate were 87.7%,71.2%,and 67.1%, respectively. Incidence of hepatomegaly splenomegaly, and rash were 67.1%, 63.0%, 17.8% and 16.7%. Counts of WBC in groupⅠwere higher than that in groupⅡ. ALT and AST in groupⅠwere lower than those in groupⅡ.The incidence rates of splenomegaly and hepatomegaly in groupⅠwere higher than those in groupⅡ. ALT abnormal rate and the age of the patients are positively related, ALT abnormal rate and fever time are positively related (P<0.05), ALT abnormal rate and hepatomegaly are independent, unrelated (P>0.05). The common complications of 2 groups were hepatic lesion pneumonia, myocardial damage, anemia and thrombocytopenia.Two groups of the complications of IM is the liver damage, and 64 cases(87.7)%, next to the touch of bronchitis or pneumonia, there are 37 cases(50.68%). ECG and the myocardium was poorly enzymes, for example, 32 ECG 9 cases are exceptions, these cells, tachycardia 5, T waves alter four, and the myocardium was poorly enzymes to 73 for example, Heighten 28 patients in CK–MB(38.4%);neutrophils reduce have 12(16.4 %);anaemia have 12(16.4%);Platelet reduce have four(5.5%),the lowest for 56×10⁹/L.Conclusion:1,There are differences between different age groups of children with EBV-IM in clinical symptoms, signs, laboratory examinations and complications of patients . For the most common complication is liver damage, followed by bronchial pneumonia.2,Small children age group IM easy happening liver splenomegaly, but of abnormal liver function in large groups relatively degree of heavy.3,ALT abnormal rate and the age of the patients are positively related and fever time , ALT abnormal rate and hepatomegaly are independent, unrelated.