Clinical analysis and follow-up study of chronic active Epstein-Barr virus infection in 53 pediatric cases

作者：Gen Lu, Zhengde Xie, Shunying Zhao, Ling-jun Ye, Runhui Wu, Chunyan Liu, Shuang Yang, Yingkang Jin, Kunling Shen · 发表于：Chinese Medical Journal · 年份：2009 · DOI：10.3760/cma.j.issn.0366-6999.2009.03.005 · 被引用次数：41 · 研究领域：Viral-associated cancers and disorders、Inflammatory Biomarkers in Disease Prognosis、Cytomegalovirus and herpesvirus research

BACKGROUND: Chronic active Epstein-Barr virus infection (CAEBV) has been previously reported to be sometimes associated with an aggressive clinical course. The characteristics of CAEBV in Mainland Chinese pediatric patients are largely unreported. The main aims of this survey were to recognize the clinical features of CAEBV in children and to explore its diagnostic criteria and risk factors. METHODS: A retrospective study was performed on 53 pediatric patients (36 boys and 17 girls) with CAEBV who were admitted to Beijing Children's Hospital between 2003 and 2007. All their medical records were reviewed and analyzed. For each patient, demographic, clinical, laboratory data and outcome were collected. Independent-samples t test was used for statistical analysis. RESULTS: The age at onset of CAEBV was from 2 months to 14.6 years (mean (5.3+/-3.3) years). At the time of onset, 43.4% patients had an infectious mononucleosis-like symptom. Most patients exhibited intermittent fever (92.5%, 49/53), hepatomegaly (81.1%, 43/53) and splenomegaly (77.4%, 41/53). Life-threatening complications including hemophagocytic syndrome (24.5%, 13/53), interstitial pneumonia (24.5%, 13/53), hepatic failure (15.1%, 8/53) and malignant lymphoma (11.3%, 6/53) were also observed. The serum EBV DNA level in 23 patients with CAEBV was in the range of 5.05 x 10(2)-4.60 x 10(6) copies/ml with a mean value of 10(3.7) copies/ml. Many patients with CAEBV generally had continuous symptoms during the observati...