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Mazur-Melewska K, Luczak M, Watral J, Małecki P, Mania A, Figlerowicz M. The Impact of Acute EBV Infection on Changes in the Serum Proteome in Children-A Pilot Study. Pathogens 2024; 13:471. [PMID: 38921769 PMCID: PMC11206626 DOI: 10.3390/pathogens13060471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/10/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
This study investigates the impact of Epstein-Barr virus (EBV) infection on children's proteomes across different phases of the disease, utilising seventy-nine blood samples categorised into three groups: EBV-naive patients, acute infectious mononucleosis (IM) cases, and convalescents followed up for 12 months post-IM. The aim is to identify proteins influenced by EBV infection, shedding light on the chronic processes triggered by the virus. The results reveal thirty-nine proteins distinguishing between naive patients and those with IM, including actin, lumican, peroxiredoxin-2, fibulin-1, gelsolin, and alpha-2-macroglobulin, which are involved in immune responses, cell adhesion, and inflammation. Elevated oxidative stress markers like peroxiredoxin-2 in IM patients suggest potential links to EBV's induction of reactive oxygen species. Increased levels of apolipoproteins A-I, A-IV, C-IV, and M during IM imply associations with viral infection, while complement system proteins (C1q, C1r, and C8 gamma chain) are also elevated, reflecting their role in the immune response and viral clearance. This study's focus on children provides unique insights into EBV's impact on young populations, emphasising proteomics' role in uncovering protein associations and understanding the virus's long-term consequences. However, specific relationships between identified proteins and EBV infection require further investigation.
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Affiliation(s)
- Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 60-572 Poznań, Poland
| | - Magdalena Luczak
- Department of Biomedical Proteomics, Institute of Bioorganic Chemistry, Polish Academy of Sciences, 61-704 Poznań, Poland
| | - Joanna Watral
- Department of Biomedical Proteomics, Institute of Bioorganic Chemistry, Polish Academy of Sciences, 61-704 Poznań, Poland
| | - Paweł Małecki
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 60-572 Poznań, Poland
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 60-572 Poznań, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 60-572 Poznań, Poland
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Gao C, Cao L, Mei X. Clinical analysis of infectious mononucleosis complicated with acute acalculous cholecystitis. Front Pediatr 2024; 12:1339920. [PMID: 38523838 PMCID: PMC10957744 DOI: 10.3389/fped.2024.1339920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/29/2024] [Indexed: 03/26/2024] Open
Abstract
Objective This study aimed to investigate specific clinical diagnostic methods for children with infectious mononucleosis (IM) complicated by acute acalculous cholecystitis (AAC). Methods We conducted a retrospective analysis of 171 cases of IM diagnosed in the infectious disease ward of Children's Hospital of Nanjing Medical University between January 2020 and December 2020. All IM patients underwent abdominal ultrasound examinations to assess the liver, gallbladder, and spleen. Fourteen patients with symptoms of AAC underwent a follow-up assessment one week later. Results The estimated incidence of AAC in hospitalized IM children was 8.2%. Both groups of patients presented with fever, abdominal pain, and eyelid edema upon admission. Characteristic radiological findings of AAC were observed, including gallbladder (GB) distention, increased GB wall thickness and increased common bile duct diameter. Analysis of laboratory results revealed no statistically significant differences in leukocyte, absolute lymphocyte count, CD3+, CD3 + CD4+, CD3+ CD8+, Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), or Gamma-Glutamyl Transferase (GGT) levels between the AAC(+) and AAC(-) groups on admission. However, these parameters were not significant risk factors for AAC. After discharge, relevant indicators in non-AAC patients gradually decreased to normal levels, while those in AAC(+) patients did not show a significant decrease. Conclusion While cases of IM complicated by AAC are relatively uncommon, the utilization of abdominal ultrasound offers a reliable tool for confirming this diagnosis. Routine abdominal ultrasound examinations are recommended for IM patients to improve early detection and treatment of associated conditions.
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Affiliation(s)
- Caijie Gao
- Department of Infectious Disease, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Liming Cao
- Department of Infectious Disease, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoli Mei
- Department of Infectious Disease, Children's Hospital of Nanjing Medical University, Nanjing, China
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Tan ET, Wilkinson D, Edafe O. The utility of liver function tests and abdominal ultrasound in infectious mononucleosis - A systematic review. Clin Otolaryngol 2022; 47:611-619. [PMID: 35834363 DOI: 10.1111/coa.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/12/2022] [Accepted: 06/26/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION A large proportion of patients with infectious mononucleosis (IM) have abnormal liver function tests (LFT) at presentation. There is no guideline regarding the management and follow-up of these patients. Some patients also have abdominal ultrasound due to deranged LFT, the need for this practice is unclear. The aim of this systematic review was to evaluate the evidence base on LFT assessment in IM, time to resolution of derangement, and the role of abdominal ultrasound (US). METHODS A systematic search of PubMed, EMBASE and the Cochrane library was done. Two authors independently screened records for eligibility using pre-defined criteria. We included both adult and paediatric populations. Quality assessment of included studies was done. RESULTS A total of 3924 patients were included from 32 studies, of which LFT values were reported on 2779 patients. A combination of typical clinical features, heterophile antibodies and EBV-specific antibodies were used to ascertain diagnosis. The following proportion of patients had abnormal LFTs: AST (57%); ALT (62%); ALP (65%); Bilirubin (16%); GGT (41%). Reported median (i.q.r.) time to resolution of LFT was 8 (6-12) weeks (n = 438). Maximum time to resolution was >6 months. Clinical hepatomegaly and splenomegaly were found in 35% and 44% of patients respectively. Enlarged liver and spleen on US were seen in 16/29 and 38/38 of patients respectively. There were no reports of decompensated liver disease. CONCLUSION Current evidence questions the need for routine assessment of LFTs in immunocompetent patients presenting with IM; serial LFT assessments following initial abnormalities are not required in immunocompetent patients with subclinical derangement of LFTs; routine US abdomen in IM to evaluate for derangement of LFTs is not required.
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Affiliation(s)
- E Tian Tan
- Barnsley Hospital NHS Foundation Trust, UK
| | | | - Ovie Edafe
- Oncology & Metabolism, University of Sheffield, UK
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BONINSEGNA SARA, STORATO SILVIA, RICCARDI NICCOLÒ, SOPRANA MARCO, OLIBONI EUGENIO, TAMAROZZI FRANCESCA, BOCUS PAOLO, MARTINI MARIANO, FLOREANI ANNAROSA. Epstein-Barr Virus (EBV) acute acalculous cholecystitis in an immunocompromised adult patient: a case report and a literature review of a neglected clinical presentation. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E237-E242. [PMID: 34322642 PMCID: PMC8283645 DOI: 10.15167/2421-4248/jpmh2021.62.1.1859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/22/2020] [Indexed: 12/02/2022]
Abstract
Primary Epstein-Barr virus (EBV) infection may present with self-limiting abdominal involvement, characterized by hepatitis with mild elevation of aminotransferases, splenomegaly, and rarely with acute acalculous cholecystitis (AAC). Usually, treatment of EBV related AAC is symptomatic, without the need for surgery. Here, we describe a severe case of AAC occurring as the first manifestation of infectious mononucleosis in a young adult woman, receiving treatment with interleukin 6 receptor (IL-6r) inhibitor for rheumatoid arthritis (RA); moreover, we have performed a review of the literature on EBV-related AAC.
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Affiliation(s)
- SARA BONINSEGNA
- Department of Gastroenterology and Endoscopy, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - SILVIA STORATO
- Department of Gastroenterology and Endoscopy, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - NICCOLÒ RICCARDI
- Department of Infectious, Tropical Diseases & Microbiology (DITM), IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
- Correspondence: Niccolò Riccardi, Infectious and Tropical Medicine Specialist, IRCCS Sacro Cuore Don Calabria Hospital - E-mail:
| | - MARCO SOPRANA
- Division of General Medicine, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - EUGENIO OLIBONI
- Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - FRANCESCA TAMAROZZI
- Department of Infectious, Tropical Diseases & Microbiology (DITM), IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - PAOLO BOCUS
- Department of Gastroenterology and Endoscopy, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - MARIANO MARTINI
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Italy
| | - ANNAROSA FLOREANI
- University of Padova, Italy - IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
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Wu Y, Ma S, Zhang L, Zu D, Gu F, Ding X, Zhang L. Clinical manifestations and laboratory results of 61 children with infectious mononucleosis. J Int Med Res 2020; 48:300060520924550. [PMID: 33045888 PMCID: PMC7563853 DOI: 10.1177/0300060520924550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objective To investigate the clinical manifestations of infectious mononucleosis in children of different ages. Methods Clinical data from pediatric patients with infectious mononucleosis admitted from May 2015 to April 2019 were retrospectively analyzed. Patients were stratified into three groups (age 1–3 years, 4–6 years, and 7–14 years) for analysis of clinical and laboratory results. Results Data from 61 patients (male:female ratio 1.18:1) aged 5.15 ± 2.93 years (mean ± standard deviation; range: 1–14 years) were analyzed. Infectious mononucleosis occurred throughout the year and the main clinical manifestations were fever (98.3%), tonsillitis (100%), tonsillar white exudate (83.6%), cervical lymphadenopathy (98.3%), hepatomegaly (37.7%), splenomegaly (42.6%), eyelid edema (41.0%), and nasal obstruction (49.2%). Disease onset was most common during early childhood (37.7%) and at preschool age (37.7%). Younger children had more obvious symptoms of nasal obstruction and older children had more significant elevations of alanine aminotransferase and higher percentages of atypical lymphocytes. Conclusion The clinical manifestations of infectious mononucleosis in children differed by age. These associations required attention for clinical decision making.
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Affiliation(s)
- Yanming Wu
- Department of Pediatrics, People's Hospital of Shanghai Pudong New District, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Suli Ma
- Department of Pediatrics, People's Hospital of Shanghai Pudong New District, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Lingjun Zhang
- Department of Pediatrics, People's Hospital of Shanghai Pudong New District, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Daoming Zu
- Department of Pediatrics, People's Hospital of Shanghai Pudong New District, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Fangjin Gu
- Department of Pediatrics, People's Hospital of Shanghai Pudong New District, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Xiaoyuan Ding
- Department of Pediatrics, People's Hospital of Shanghai Pudong New District, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Lei Zhang
- Department of Pediatrics, People's Hospital of Shanghai Pudong New District, Shanghai University of Medicine and Health Sciences, Shanghai, China
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