Analysis Of Visceral Function Impairment And Prognosis In Children With Epstein-Barr Virus Infection Associated Diseases

Background:Epstein-Barr virus(EBV)infection-associated diseases are common diseases in children,including infectious mononucleosis(IM),EBV Infection-associated hemophagocytic lymphohistiocytosis(EBV-HLH)and Chronic Active Epstein-Barr Virus Infection(CAEBV).These diseases have diffreent clinical manifestations and progosis,they can be transformed into each other,causing liver function damage,renal function damage and other organs damage.The treatment programs are not identical in three diseases.Objictive:To analyze the visceral function impairment and prognostic factors in children with the above three EBV infection-related diseases,and improve early dection and treatment of organ dysfunction.Methods:We searched the medical records of children with IM、EBV-HLH、CAEBV admitted in the pediatric department of a general hospital in Henan province form Jan 1st,2013 to Oct 1st,2017.A uniform clinical data collection cards were designed.To collect and summarize the age of disease’s onset,laboratory examination results at the early onset and prognosis of the three diseases.Folloe-up visits were conducted in the form of a combination of inpatient and outpatient care.According to whether there was liver function damage,IM was diveded into abnormal liver function group and normal group.According to prognosis,the EBV-HLH and CAEBV were divided into survival group and death group.SPSS 21.0was used for statistical analysis of datas,count datas were analyzed by chi-square and corrective chis-quare test.Measurement datas were taken as two independent sample tests or non-parametric test,with p<0.05 being statistically significant.Results:1.A total of 663 cases of EBV-associated diseases were included,among which 400 cases were IM,70 cases were EBV-HLH,and 18 cases were CAEBV.In the age of disease’s onset,the IM accounted for<7 years old,EBV-HLH accounted for<3 years old,and CAEBV accounted for?3 years old.2.The proportion of liver damage in IM cases was 56.25%,there were statistical differernce in CD4~+T,CD8~+T lymphocytes,CD4/CD8,and IgG in comparision between abnormal liver function and normal group in the early stage,there were no statistically significant difference in NK cells,IgM,IgE,IgA,and EBV-DNA.3.In the 70 cases of EBV-HLH,there were all different degrees of organ damage in the early stage,of which 2~4 organs dysfunction were more.In the 18cases of CAEBV,there was 1 organ dysfunction were more.The liver was the most commonly organ damage of both diseases in the early stage.4.In the 70 cases of EBV-HLH,there was a statiscially significant difference in platelet and albumin between the survival and the death groups at the early stage of the disease,while there was no statiscially significant difference in the white blood cells,neutrophils,hemoglobin,ferritin,total bilirubin,age of onset,and organ damage at the onset of disease.5.In the 18 cases of CAEBV,there was a statiscially significant difference in albumin between the survival and the death groups at the early stage of the disease,while there was no statiscially significant difference in the platelet counts,white blood cells,neutrophils,hemoglobin,ferritin,total bilirubin,age of onset,and organ damage at the onset of disease.Conclusions:1.Prevalence of IM cases during the perschool period,EBV-HLH cases during the infance and young period,CAEBV cases during the preschool and school age period were high.2.There are many cases of liver damage in IM cases,and the liver was also the most common injured organ of children with EBV-HLH and CAEBV at the early stage of disease’s.3.The low platelet and low albumin levels in the early stage of the EBV-HLH disease and the low albumin levels in the early stage of the CAEBV disease may indicate poor prognosis.