| ObjectiveTo summarize the clinical features,laboratory examination and treatment outcome of epstein-barr virus infection-related hemophagocytic lymphohistiocytosis(EBV-HLH)in children,so as to improve the early diagnosis and treatment of this disease and improve the prognosis.MethodsClinical data and laboratory tests of 21 children who were admitted to the children’s hospital affiliated to Soochow University and diagnosed asdiagnosed as EBV-HLH from July 2016 to April 2019 were retrospectively analyzed.Analysis:21 cases of children with EBV-HLH as observation group,with the same period in our hospital diagnosed as EB virus infection of infectious mononucleosis(EBV-IM)of 205 cases as control group,the clinical records of two groups of children with data,laboratory examination,such as comparing the indicators,and using SPSS 22.0 statistical software including age,gender,incidence,clinical manifestation,laboratory examination and treatment outcome,such as data processing and statistical analysis,P<0.05,with statistical significance.Results1.There were 10 cases of EBV-HLH in males and 11 cases in females,with a male-female ratio of 1:1.The mean age was 5.5±3.96 years old,and the median age was 3.25 years old.Among them,0 cases were<1 years old,9 cases were 1～3 years old,4 cases were 3～6 years old,4 cases were 6～10 years old,and 4 cases were>10 years old.The peak age of onset was in children aged 1 to 3 years.2.All children with EBV-HLH had fever(86.83%),pharyngitis(97.07%),cervical lymph node enlargement(71.43%),hepatomegaly(66.67%),splenomegaly(57.14%),but few children with rash in clinical manifestations(4.88%).3.There were differences between EBV-HLH group and EBV-IM group in the length of fever,degree of hepatosplenomegaly and positive rate of cervical lymph node enlargement,and the ebv-hlh group had significant differences in the length of fever,degree of hepatosplenomegaly and positive rate of cervical lymph node enlargement(p<0.05).4.Comparison of laboratory tests between EBV-HLH group and EBV-IM group showed that WBC,NE,MO,HB and PLT indexes in blood routine were significantly lower than those in EBV-IM group,and the difference between the two groups was statistically significant(p<0.05).In terms of coagulation function,the indicators of D-Dimer,PT and APTT were significantly higher than those of EBV-IM group,and FIB was significantly lower than those of EBV-IM group,with statistically significant differences between the two groups(p<0.05).Compared with EBV-IM group,the indexes of AST,ALT,LDH,SF and TG were significantly higher than those of EBV-IM group(p<0.05).Peripheral blood lymphocyte subgroup percentage in the comparison,found that the percentage of CD3+ T cells and CD8+ T cell percentage,the percentage of NK cells,higher than that of EBV-IM group,CD4+T cell percentage,CD4/CD8 ratio,B cell percentage was lower than that in group EBV-IM,and compare the difference was statistically significant(p<0.05),peripheral blood lymphocyte subgroup absolute count is found on the lymphocyte count,CD3+T cell count and CD4+T cell count,CD8+T cell count,NK cell count,and B cell count were significantly lower than that of EBV-IM group,The difference was statistically significant(p<0.05).In terms of humoral immunity and complement indexes,IgA,IgG and IgM in EBV-HLH group were significantly lower than those in EBV-IM group,and the difference between the two groups was statistically significant(p<0.05).Comparison of ebv-dna total blood and plasma copy number showed that EBV-DNA total blood and plasma copy number in EBV-HLH group was significantly higher than that in EBV-IM group,and the difference was statistically significant(p<0.05).5.1n the 21 children in EBV-HLH group,the positive rate of hemophagy found in bone biopsy was 66.67%,the proportion of NK cell activity decreased was 90.48%,and the proportion of soluble cd25 level increased was 85.71%.6.For the treatment and outcome of 21 children in the EBV-HLH group,it was found that the total effective rate of all 21 children in the EBV-HLH group was 47.6%,and there was a statistically significant difference in the diagnosis time between the two types of children in the EBV-HLH group:improvement and deterioration(p<0.05).Conclusion1.The peak age of onset of EBV-HLH children is 1-3 years old,with diverse clinical manifestations and critical condition,so relevant examinations should be improved for early diagnosis..2.In laboratory examination of EBV-HLH children,hematological indicators,coagulation function,liver function and immunological indicators were significantly abnormal,the whole blood and plasma copy Numbers of EBV-DNA were significantly increased,and the NK cell activity and soluble CD25 level abnormalities were more sensitive in the diagnosis of EBV-HLH children than those of bone perforation. |
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