The Spectrum Of EBV-associated Disorders And Wei Qi Ying Xue Differentiation Of Symptoms And Signs

Objective.Epstein-Barr virus (EBV) infection is common in childhood, which would induce a lot of clinical entities. EBV infection can involve in any organ, which lead to many clinical symptom and multiplex spectrum of diseases. Recently, there are many studys about EBV in the world. However, simple entity as a disease is ofen reported, but no one study systematically on spectrum of diseases for EBV infection. There is not evaluation about severe EBV infection (SEBV) and chronic active EBV infection (CAEBV). We investigated the date of children with EBV infected retrospectively in order to comprehend and analyse the spectrum of EBV-associated disorders, and analyse with differentiate the development of a seasonal febrile disease by studying the four stages: WEI, QI, YING and XUE. Using the methods of regression analysis, for getting an early diagnosis and an index of warning, we will compare the prognosis-associated risk factors in the both the patients with severe EBV infection and with CAEBV.Methods.During the January 2003 to June 2004 period, a total of 332 patients with EBV infection were consecutively registered in TIANJIN CHILDREN'S HOSPITAL. The clinical dates were collected, including sex, age, symptoms and signs, primary diagnosis and pertinent laboratory numerical data. EBV DNA detected by PCR and EBVCA-IgM by enzyme-linked immunosorbent assay (ELISA) was confirmed in the patients'serum or cerebrospinal fluid. Accodding to the results of the test, the patients divided into 2 groups: called EBV VCA IgM positive group and EBV DNA positive group. The spectrum of EBV-associated disorders was studied, and also differentiated the evol of a seasonal febrile disease for all patients to be discriminated in the four stages such as WEI, QI, YING and XUE.Results.1. There is a wide spectrum of clinical presentations, which are characterized by any organ likely to be affected. The disorders of respiratory system were very common in all patients with EBV infection, followed by infectious mononucleosis, hematological system, nervous system, respectively. In the most patients with EBV infection, although, the clinical presentations were not predominant, but the severe states were not uncommon. Eight patients had documented chronc active EBV infection.2. Sixty-six patients with severe EBV infection had severe hepatic lesions with prominently elevated level of the enzyme and high EBV DNA load in the samples, and levels of the copy values was higher than children with the common EBV infection (p< 0.05). By Logistic regression analysis, sex, age, lymphadenectasis, splenohepatomegalia, neutrophil, blood platelet, severe hepatic lesion were not related with the prognosis, but, the long-time fever, EBV DNA numerical value, level of haematochrome and leukocyte were related.3. Eight patients with multisystem disorders met the diagnostic criteria for chronic actice EBV infection. Of the course was much longer and, the prognosis was poor. EBV DNA load was higher than patients with SEBV, but VCA-IgM-negative in these patients (87.5%).4. Wei Qi Ying Xue patterns of syndrome of different disease are different(p< 0.05). Wei Fen and Qi Fen were considerable for patients with upper respiratory tract disorders. Qi Fen was considerable for patient with pneumonia. Qi Fen and Ying Fen were about comparative for infectious mononucleosis. Ying Fen is considerable for nervous system disorders. Ying Fen is considerable for CAEBV. Xue Fen account a portion of percentage.Conclusion. 1. EBV infection in childhood is involved to multisystem, which lead to the...