1
|
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.
Collapse
Affiliation(s)
- E Tian Tan
- Barnsley Hospital NHS Foundation Trust, UK
| | | | - Ovie Edafe
- Oncology & Metabolism, University of Sheffield, UK
| |
Collapse
|
2
|
Fedyanina OS, Filippova AE, Demina OI, Zhuliabina OA, Tikhomirov DS, Filatov AV, Chebotareva TA, Kuznetsova SA. The Nature and Clinical Significance of Atypical Mononuclear Cells in Infectious Mononucleosis Caused by the Epstein-Barr Virus in Children. J Infect Dis 2021; 223:1699-1706. [PMID: 32959062 DOI: 10.1093/infdis/jiaa601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/17/2020] [Indexed: 11/13/2022] Open
Abstract
Atypical mononuclear cells (AM) appear in significant numbers in peripheral blood of patients with Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM). We investigated the number and lineage-specific clusters of differentiation (CD) expression of atypical mononuclear cells in 110 children with IM using the anti-CD antibody microarray for panning leukocytes by their surface markers prior to morphology examination. The AM population consisted primarily of CD8+ T cells with a small fraction (0%-2% of all lymphocytes) of CD19+ B lymphocytes. AM amount in children with mononucleosis caused by primary EBV infection was significantly higher than for IM caused by EBV reactivation or other viruses and constituted 1%-53% of all peripheral blood mononuclear cells compared to 0%-11% and 0%-8%, respectively. Children failing to recover from classic IM associated with primary EBV infection within 6 months had significantly lower percentage of CD8+ AM compared to patients with normal recovery rate.
Collapse
Affiliation(s)
- Olga S Fedyanina
- Dmitry Rogachev National Research Centre for Pediatric Hematology, Oncology and Immunology, Moscow, Russia.,Centre for Theoretical Problems of Physicochemical Pharmacology RAS, Moscow, Russia
| | - Anna E Filippova
- Dmitry Rogachev National Research Centre for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Olga I Demina
- Moscow Children's Hospital named after Z. A. Bashlyaeva, Moscow, Russia.,Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Olga A Zhuliabina
- Department of Biophysics, Faculty of Physics, M. V. Lomonosov Moscow State University, Moscow, Russia
| | | | | | - Tatiana A Chebotareva
- Moscow Children's Hospital named after Z. A. Bashlyaeva, Moscow, Russia.,Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Sofya A Kuznetsova
- Dmitry Rogachev National Research Centre for Pediatric Hematology, Oncology and Immunology, Moscow, Russia.,Centre for Theoretical Problems of Physicochemical Pharmacology RAS, Moscow, Russia
| |
Collapse
|
3
|
Alli A, Nabil F, Ortiz JF. Infectious Mononucleosis: A Case Report With Unusual Features and Abnormal Laboratory Findings. Cureus 2021; 13:e14790. [PMID: 34094752 PMCID: PMC8169128 DOI: 10.7759/cureus.14790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Despite the widespread Epstein-Barr virus (EBV) infections, we continue to see new reports with strange and unusual manifestations of the infection, which raises the question of how well we understand this pathogen. The age of contracting the infection is increasing in developed countries, which is changing the clinical presentation of those who get infected during their adolescence or early adulthood. In these stages, liver involvement is more prominent, and other physical symptoms are less apparent. Therefore, an update on infectious mononucleosis (IM) variable manifestation is required to make healthcare providers aware of this shift. This case stands as an example of the new shift as a patient scheduled for elective surgery suddenly presented with subclinical hepatitis caused by primary EBV infection. Our patient presented with few physical symptoms but had a classical picture of EBV-induced hepatitis on blood analysis. The diagnosis was missed by many physicians due to the varied presentations of IM. This case corresponds to the new evidence that suggests that hepatic involvement is one of the most prominent manifestation in the adult population with primary EBV infection.
Collapse
Affiliation(s)
- Ammar Alli
- Internal Medicine, Tishreen University Faculty of Medicine, Latakia, SYR.,Internal Medicine, Universitat de Barcelona, Barcelona, ESP
| | - Farah Nabil
- Faculty of Health Sciences, University of Zaragoza, Zaragoza, ESP
| | - Juan Fernando Ortiz
- Neurology, Universidad San Francisco de Quito, Quito, ECU.,Neurology, Larkin Community Hospital, Miami, USA
| |
Collapse
|
4
|
Jahani MA, Alinasab Z, Rezapour M, Omrani Nava M, Mahmoudi G. Pattern of infectious diseases in northern Iran: An approach to internal medicine management. CASPIAN JOURNAL OF INTERNAL MEDICINE 2021; 12:275-282. [PMID: 34221276 PMCID: PMC8223039 DOI: 10.22088/cjim.12.3.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 12/30/2020] [Accepted: 01/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite the development of their prevention and treatment, infectious diseases cause high mortality, many disabilities and inadequate living conditions worldwide. The aim of this study was to evaluate the pattern of infectious diseases in northern Iran with an approach to internal medicine management. METHODS This cross-sectional research was conducted in 2019 on all 7095 infectious diseases patient records that referred to Ghaemshahr Razi Hospital, Mazandaran Province, Iran during 2012-2018. A checklist prepared by investigator was used to collect the data. The extracted data were coded and entered into SPSS 22 and analyzed using K2 and independent t-test at p<.05. RESULTS The mean age of the study patients was 29.7±26.4. 4372 (61%) of the cases were males and the mean duration of hospitalization was 41.6±33.5. Age was significantly correlated to infectious diseases (P=.001). Gastroenteritis was the most common infectious disease among the men and women with 2442 (60.5%) and 1594 (39.47%), respectively. Based on the Pearson's correlation test, the relationship between leptospirosis, brucellosis, pulmonary tuberculosis, shigellosis, sepsis and infectious mononucleosis with gender, habitation, admission mode, discharged mode and age was significant (p<.05). CONCLUSION As the high frequent diseases were gastroenteritis, leptospirosis, brucellosis and sepsis and an increasing trend was in the prevalence of gastroenteritis, leptospirosis and lung tuberculosis, health system managers should consider training courses, preventive strategies, real-time interventions, increased hospital bed rate for patients with infectious diseases and so on.
Collapse
Affiliation(s)
- Mohammad Ali Jahani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zohreh Alinasab
- Hospital Administration Research Center, Sari Branch, Islamic Azad University, Sari, Iran
| | - Maysam Rezapour
- School of Nursing and Midwifery, Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Melodi Omrani Nava
- Hospital Administration Research Center, Sari Branch, Islamic Azad University, Sari, Iran
| | - Ghahraman Mahmoudi
- Hospital Administration Research Center, Sari Branch, Islamic Azad University, Sari, Iran
| |
Collapse
|
5
|
TLR4 896A/G and TLR9 1174G/A polymorphisms are associated with the risk of infectious mononucleosis. Sci Rep 2020; 10:13154. [PMID: 32753695 PMCID: PMC7403730 DOI: 10.1038/s41598-020-70129-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023] Open
Abstract
Toll-like receptors (TLRs) recognize pathogen-associated molecular patterns and activate innate and adaptive immune responses. Single nucleotide polymorphisms (SNPs) within the TLR genes may influence host–pathogen interactions and can have an impact on the progression of infectious diseases. The present study aimed to investigate the genotype distribution of TLR2 (2029C/T, rs121917864; 2258G/A, rs5743708), TLR4 (896A/G, rs4986790), and TLR9 (− 1237T/C, rs5743836; − 1486T/C, rs187084; 1174G/A, rs352139; and 2848C/T, rs352140) polymorphisms in 149 children and adolescents with infectious mononucleosis (IM) and 140 healthy individuals. The potential association of TLR SNPs with the clinical manifestations of EBV infection was also studied. The presence of TLR2, TLR4, and TLR9 SNPs was identified by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP). EBV DNA loads were detected by quantitative real-time PCR assay. The TLR4 896 GG and the TLR9 1174 GA genotypes were associated with an increased risk of EBV-related IM in examined patients (p = 0.014 and p = 0.001, respectively). The heterozygous genotype of the TLR4 896A/G SNP was associated with an increased risk of elevated liver enzyme levels and leukocytosis (p < 0.05). Our preliminary study revealed that the TLR4 896A/G and the TLR9 1174G/A polymorphisms seem to be related to the course of acute EBV infection in children and adolescents.
Collapse
|
6
|
Rostgaard K, Balfour HH, Jarrett R, Erikstrup C, Pedersen O, Ullum H, Nielsen LP, Voldstedlund M, Hjalgrim H. Primary Epstein-Barr virus infection with and without infectious mononucleosis. PLoS One 2019; 14:e0226436. [PMID: 31846480 PMCID: PMC6917282 DOI: 10.1371/journal.pone.0226436] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/26/2019] [Indexed: 02/06/2023] Open
Abstract
Background Infectious mononucleosis (IM) is a common adverse presentation of primary infection with Epstein-Barr virus (EBV) in adolescence and later, but is rarely recognized in early childhood where primary EBV infection commonly occurs. It is not known what triggers IM, and also not why IM risk upon primary EBV infection (IM attack rate) seemingly varies between children and adolescents. IM symptoms may be severe and persist for a long time. IM also markedly elevates the risk of Hodgkin lymphoma and multiple sclerosis for unknown reasons. The way IM occurrence depends on age and sex is incompletely described and hard to interpret etiologically, because it depends on three quantities that are not readily observable: the prevalence of EBV-naϊve persons, the hazard rate of seroconverting and the attack rate, i.e. the fraction of primary EBV infections that is accompanied by IM. We therefore aimed to provide these quantities indirectly, to obtain epidemiologically interpretable measures of the dynamics of IM occurrence to provide etiological clues. Methods and findings We used joint modeling of EBV prevalence and IM occurrence data to provide detailed sex- and age-specific EBV infection rates and IM attack rates and derivatives thereof for a target population of all Danes age 0–29 years in 2006–2011. We demonstrate for the first time that IM attack rates increase dramatically rather precisely in conjunction to typical ages of puberty onset. The shape of the seroconversion hazard rate for children and teenagers confirmed a priori expectations and underlined the importance of what happens at age 0–2 years. The cumulative risk of IM before age 30 years was 13.3% for males and 22.4% for females. IM is likely to become more common through delaying EBV infection in years to come. Conclusions The change in attack rate at typical ages of puberty onset suggests that the immunologic response to EBV drastically changes over a relatively short age-span. We speculate that these changes are an integrated part of normal sexual maturation. Our findings may inform further etiologic research into EBV-related diseases and vaccine design. Our methodology is applicable to the epidemiological study of any infectious agent that establishes a persistent infection in the host and the sequelae thereof.
Collapse
Affiliation(s)
- Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- * E-mail:
| | - Henry H. Balfour
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical Center, Minneapolis, MN, United States of America
- Department of Pediatrics, University of Minnesota Medical Center, Minneapolis, MN, United States of America
| | - Ruth Jarrett
- MRC—University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, United Kingdom
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Pedersen
- Department of Clinical Immunology, Næstved Hospital, Næstved, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Haematology, Copenhagen University Hospital, Copenhagen, Denmark
| |
Collapse
|
7
|
García-Peris M, Jiménez Candel MI, Mañes Jiménez Y, Pariente Martí M, González Granda D, Calvo Rigual F. Primoinfección por el virus de Epstein-Barr en niños sanos. An Pediatr (Barc) 2019; 90:376-385. [DOI: 10.1016/j.anpedi.2018.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/05/2018] [Accepted: 09/10/2018] [Indexed: 11/26/2022] Open
|
8
|
García-Peris M, Jiménez Candel MI, Mañes Jiménez Y, Pariente Martí M, González Granda D, Calvo Rigual F. Epstein–Barr virus primary infection in healthy children. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.anpede.2018.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
|
9
|
El-Amrani-Joutey M, Jiménez-García R, Linares-García-Valdecasas R, Palomar-Gallego MA, Jiménez-Trujillo I, López-de-Andrés A, Vázquez-Vázquez L. Infection by Epstein-Barr virus in Fes (Morocco). Prevalence and predictors of positivity in nasopharyngeal cancer. J Infect Public Health 2018; 11:807-811. [PMID: 29871843 DOI: 10.1016/j.jiph.2018.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/10/2018] [Accepted: 05/13/2018] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES To determine the prevalence and genotypic distribution of Epstein-Barr virus (EBV) in a sample of patients of Hassan II University Hospital (Morocco) due to nasopharyngeal pathologies and requiring a biopsy. We identified factors associated to the EBV infection. METHODS 112 patients were recruited (January 2012-October 2014). Biopsies were conducted for the molecular diagnosis of EBV. The data collected included sociodemographic characteristics, smoking and drug abuse, medical background and histologic diagnosis. The EBV diagnosis was performed via the Polymerase Chain Reaction. RESULTS 50% of patients were infected by EBV (98.2% with EBV type A compared to 1.8% type B). Most infected patients were ≥40years(65.5%), male (59.6%) and in unfavorable socioeconomic circumstances. 83.3% of patients with lymphoma and 69.8% of patients with nasopharyngeal carcinoma presented concomitant EBV infections. 88.9% of patients who took drugs were infected by EBV compared to 47.7% of those who did not. In the multivariate analysis, age (OR 1.03; IC95% 1.02-1.06), smoking (OR 4.28; IC95%1.24-14.78) and having a malignant process (OR 6.96; IC95% 2.26-21.44) were significantly associated with EBV. CONCLUSIONS Infection by EBV is related to several factors, such as advanced age, smoking, and suffering a malignant process. In subjects with malignant pathologies, positivity to EBV seems to be inferior to that found in other countries.
Collapse
Affiliation(s)
- Mehdi El-Amrani-Joutey
- Human Anatomy and Embryology Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Madrid, Spain
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Madrid, Spain.
| | | | - María A Palomar-Gallego
- Human Anatomy and Embryology Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Madrid, Spain
| | - Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Madrid, Spain
| | - Ana López-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Madrid, Spain
| | - Luis Vázquez-Vázquez
- Human Anatomy and Embryology Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Madrid, Spain
| |
Collapse
|
10
|
Lee S, Chung JY, Park JJ, Seo JH, Kim JY, Yeom JS, Park ES, Lim JY, Woo HO, Youn HS. Clinical features of Epstein-Barr Virus-associated Infectious Mononucleosis According to Age Group in Children. KOSIN MEDICAL JOURNAL 2018. [DOI: 10.7180/kmj.2018.33.3.347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Soram Lee
- Department of Pediatrics, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea
| | - Ju-Young Chung
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jung Je Park
- Department of Otolaryngology, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea
| | - Ji-Hyun Seo
- Department of Pediatrics, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea
| | - Jae Young Kim
- Department of Pediatrics, Gyeongsang National University Hospiratal, Changwon, Korea
| | - Jung Sook Yeom
- Department of Pediatrics, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea
| | - Eun-Sil Park
- Department of Pediatrics, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea
| | - Jae-Young Lim
- Department of Pediatrics, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea
| | - Hyang-Ok Woo
- Department of Pediatrics, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea
| | - Hee-Shang Youn
- Department of Pediatrics, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea
| |
Collapse
|
11
|
Fourcade G, Germi R, Guerber F, Lupo J, Baccard M, Seigneurin A, Semenova T, Morand P, Epaulard O. Evolution of EBV seroprevalence and primary infection age in a French hospital and a city laboratory network, 2000-2016. PLoS One 2017; 12:e0175574. [PMID: 28414725 PMCID: PMC5393566 DOI: 10.1371/journal.pone.0175574] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/28/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND According to rare studies, the age at EBV primary infection (PI) has recently risen in some developed countries. A later age at infection is generally considered a risk factor for severe EBV PI, although few studies exist on this subject. Our investigation aimed to determine whether EBV seroprevalence and EBV PI epidemiology have evolved in France, and to what extent age and infection intensity (regarding biological parameters) are correlated. METHODS AND FINDINGS We conducted a retrospective study of the following EBV serological tests databases: tests carried out at Grenoble University Hospital (2000-2016) (n = 53,553); and tests carried out by a network of city laboratories in Grenoble area (2008-2015) (n = 27,485). The hospital population showed a continuous, significant decrease in EBV seroprevalence over the studied period for patients aged 20 and over (p<0.01). The seroprevalence also decreased for different age classes (<10, 15-19, 20-30, and 30-40 years old) over the periods 2001-2005, 2006-2010, and 2011-2015. Consistently, the age at PI was significantly higher in the years 2008-2015 than in the years 2001-2007 (15.6±12.0 vs. 13.7±11.0; p = 0.03). The city laboratory population showed the same trend of decreasing seroprevalence (p = 0.06); no significant variations in age at PI were observed. The age at PI was positively correlated with ASAT, ALAT, γGT, and bilirubin blood levels (p<0.01) and negatively correlated with platelet counts (p<0.05). CONCLUSION In the last 15 years, the age at EBV PI has increased, whereas seroprevalence has decreased. Moreover, our findings confirm the positive correlation between age and biological abnormalities. Taken together, these results suggest that the incidence of severe EBV PI will increase in the future.
Collapse
Affiliation(s)
- Grégoire Fourcade
- Infectious Disease Unit, Grenoble University Hospital, Grenoble, France
- Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, France
| | - Raphaele Germi
- Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, France
- Laboratory of Virology, Grenoble University Hospital, Grenoble, France
- Team “HIV and other persistent human viruses”, Institut de Biologie Structurale, UMR5075 CEA-CNRS-UGA, Grenoble, France
| | | | - Julien Lupo
- Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, France
- Laboratory of Virology, Grenoble University Hospital, Grenoble, France
- Team “HIV and other persistent human viruses”, Institut de Biologie Structurale, UMR5075 CEA-CNRS-UGA, Grenoble, France
| | - Monique Baccard
- Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, France
- Laboratory of Virology, Grenoble University Hospital, Grenoble, France
| | - Arnaud Seigneurin
- Unité d'évaluation médicale, Grenoble University Hospital, Grenoble, France
- Techniques de l'Ingénierie Médicale et de la Complexité - Informatique Mathématiques et Applications Grenoble, Unité Mixte de Recherche, Grenoble, France
| | - Touyana Semenova
- Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, France
- Laboratory of Virology, Grenoble University Hospital, Grenoble, France
| | - Patrice Morand
- Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, France
- Laboratory of Virology, Grenoble University Hospital, Grenoble, France
- Team “HIV and other persistent human viruses”, Institut de Biologie Structurale, UMR5075 CEA-CNRS-UGA, Grenoble, France
| | - Olivier Epaulard
- Infectious Disease Unit, Grenoble University Hospital, Grenoble, France
- Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, France
- Team “HIV and other persistent human viruses”, Institut de Biologie Structurale, UMR5075 CEA-CNRS-UGA, Grenoble, France
- * E-mail:
| |
Collapse
|
12
|
Al Ramzi A, Kassem M, Barghash A. Temporary unilateral hypoglossal nerve palsy secondary to infectious mononucleosis: A case report. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.fdj.2016.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
13
|
Rochford R. Epstein-Barr virus infection of infants: implications of early age of infection on viral control and risk for Burkitt lymphoma. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2016; 73:41-46. [PMID: 29421232 DOI: 10.1016/j.bmhimx.2015.12.001] [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: 12/02/2015] [Accepted: 12/03/2015] [Indexed: 11/17/2022] Open
Abstract
Since its first description by Denis Burkitt, endemic Burkitt's lymphoma (BL), the most common childhood cancer in sub-Saharan Africa, has led scientists to search for clues to the origins of this malignancy. The discovery of Epstein-Barr virus (EBV) in BL cells over 50 years ago led to extensive sero-epidemiology studies and revealed that rather than being a virus restricted to areas where BL is endemic, EBV is ubiquitous in the world's population with an estimated greater than 90% of adults worldwide infected. A second pathogen, Plasmodium falciparum (P. falciparum) malaria is also linked to BL. In this review, we will discuss recent studies that indicate a role for P. falciparum malaria in dysregulating EBV infection, and increasing the risk for BL in children living where P. falciparum malaria transmission is high.
Collapse
Affiliation(s)
- Rosemary Rochford
- Department of Immunology and Microbiology University of Colorado School of Medicine, Aurora, CO, USA.
| |
Collapse
|
14
|
Topp SK, Rosenfeldt V, Vestergaard H, Christiansen CB, Von Linstow ML. Clinical characteristics and laboratory findings in Danish children hospitalized with primary Epstein-Barr virus infection. Infect Dis (Lond) 2015; 47:908-14. [PMID: 26308113 DOI: 10.3109/23744235.2015.1082036] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Epstein-Barr virus (EBV) positive infectious mononucleosis (IM) is a common disease in adolescents. However, IM is often considered a rare disease in early childhood. We aimed to describe the classical presentation of adolescent EBV-associated IM compared to EBV infection at younger age. METHODS All immunocompetent children hospitalized at Hvidovre University Hospital, Copenhagen between 2002 and 2013, who presented with clinical features that prompted a laboratory test for EBV, and who tested positive by presence of EBV-specific antibodies, heterophile antibodies or a positive EBV PCR were included (n = 95). RESULTS Children aged 1-2 years were the age group most commonly hospitalized with acute EBV infection (27% of the cohort), followed by teenagers aged 14-15 years (23%). Fever, cervical lymphadenopathy, tonsillitis and fatigue were the most common physical findings overall. Dividing the children into three age groups (0-4 years, 5-10 years and 11-15 years) revealed that the oldest age groups significantly more often suffered from headache, tonsillitis, sore throat, abdominal pain and nausea. Young children typically presented with a runny nose, fever, fatigue and cervical adenitis. Compared with children under 5, children aged 5-15 years more often showed lymphocytosis (84% vs 62%), elevated alanine aminotransferase (77% vs 33%) and lactate dehydrogenase (79% vs 44%). CONCLUSION EBV infection is common in young children, and children less than 3 years of age constitute the largest group of hospitalizations for acute EBV infection. EBV-associated IM should be suspected in febrile children of all ages with tonsillitis, lymphadenopathy, lymphocytosis and elevated liver enzymes.
Collapse
Affiliation(s)
- Sofie Kathrine Topp
- a From the Department of Paediatrics , Hvidovre University Hospital , Copenhagen , Denmark
| | - Vibeke Rosenfeldt
- a From the Department of Paediatrics , Hvidovre University Hospital , Copenhagen , Denmark
| | - Hanne Vestergaard
- b Statens Serum Institut, Department of Microbiological Diagnostics and Virology , Division of Diagnostics and Infection Control, State University Hospital , Copenhagen , Denmark
| | - Claus Bohn Christiansen
- c Department of Clinical Microbiology , Rigshospitalet, State University Hospital , Copenhagen , Denmark
| | | |
Collapse
|
15
|
Wang Y, Li J, Ren YY, Zhao H. The levels of liver enzymes and atypical lymphocytes are higher in youth patients with infectious mononucleosis than in preschool children. Clin Mol Hepatol 2013; 19:382-8. [PMID: 24459643 PMCID: PMC3894438 DOI: 10.3350/cmh.2013.19.4.382] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 11/04/2013] [Accepted: 11/07/2013] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND/AIMS Infectious mononucleosis (IM) is the clinical presentation of primary infection with Epstein-Barr virus. Although the literature contains a massive amount of information on IM, most of this is related specifically to only children or adults separately. In order to distinguish any differences between preschool children and youth patients, we retrospectively analyzed their demographic and clinical features. METHODS Records of patients hospitalized from December 2001 to September 2011 with a diagnosis of IM were retrieved from Peking University First Hospital, which is a tertiary teaching hospital in Beijing. The demographic data and clinical characteristics were collected. RESULTS IM was diagnosed in 287 patients during this 10-year period, with incidence peaks among preschool children (≤7 years old, 130/287, 45.3%) and youth patients (>15 and <24 years old, 101/287, 35.2%). Although the complaints at admission did not differ between these two patient groups, the incidence of clinical signs (tonsillopharyngitis, lymphadenopathy, hepatomegaly, and edema of the eyelids) was much higher in preschool children. The incidence of liver lesion and percentage of atypical lymphocytes were significantly higher in the youth group (P<0.001), and the average hospital stay was longer in this group. Pneumonia was the most common complication, and there was no case of mortality. CONCLUSIONS The incidence of IM peaks among preschool children and youth patients in Beijing, China. The levels of liver enzymes and atypical lymphocytes increase with age.
Collapse
Affiliation(s)
- Yan Wang
- Department of Infectious Diseases, Peking University First Hospital, Beijing, China
| | - Jun Li
- Department of Infectious Diseases, Peking University First Hospital, Beijing, China
| | - Yuan-Yuan Ren
- Department of Infectious Diseases, Peking University First Hospital, Beijing, China
| | - Hong Zhao
- Department of Infectious Diseases, Peking University First Hospital, Beijing, China
| |
Collapse
|
16
|
Akin F, Kocaoglu C, Solak ES, Ozdemir H, Pektas B, Arslan S. Coinfection of Plasmodium vivax and Epstein-Barr virus: case report. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2013. [DOI: 10.1016/s2222-1808(13)60016-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|