Dynamic Distribution and Clinical Value of Peripheral Lymphocyte Subsets in Children with Infectious Mononucleosis
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ORIGINAL ARTICLE
Dynamic Distribution and Clinical Value of Peripheral Lymphocyte Subsets in Children with Infectious Mononucleosis Liling Chen 1 & Xinyuan Chen 2 & Weifeng Yao 3 & Xin Wei 4 & Yujie Jiang 3 & Jingjing Guan 3 & Xiaoyuan Liu 1 & Yaosheng Xie 3 & Hong Lu 3 & Jingjing Qian 3 & Zhuo Zhang 3 & Lianfeng Wu 3 & Xiangyang Lin 3 Received: 12 December 2019 / Accepted: 22 April 2020 # Dr. K C Chaudhuri Foundation 2020
Abstract Objective To study the dynamic change of peripheral lymphocyte subsets and its clinical value in children with infectious mononucleosis (IM). Methods Thirty-six pediatric patients with IM, 19 children with IM-like symptoms but lacking the serological pattern compatible with EB virus infection, and 33 healthy children were enrolled. The changes of peripheral lymphocyte subsets were detected by flow cytometry on admission and on the fifth day of antiviral treatment, respectively. Indicators of liver function and routine blood count were also detected. Besides, the receiver operating characteristic (ROC) curve and the correlation of related indicators was analyzed. Results When IM patients were admitted, the frequency and absolute number of T, CD4−CD8+T, and CD4+CD8+T (DPT) cells were significantly increased while B cells were decreased; the frequency of CD4+CD8−T cells were decreased, but its absolute number did not change significantly; the frequency of NK cells decreased, but its absolute number increased. The absolute number of CD4−CD8+T most significantly positively correlated with serum lactate dehydrogenase (LDH) concentration which could reflect the severity of IM patients. After short-term treatment with acyclovir, elevated lymphocytes decreased, but only DPT-cell frequency and NK-cell absolute number were recovering towards normal. The ROC curve suggested that the frequency of B cells has better diagnostic value for IM in pediatric patients compared to other lymphocyte subsets. Conclusions Peripheral lymphocyte subsets are closely related to the condition of children with IM, and each subset plays a relatively different role in the diagnosis and evaluation of IM. Keywords Lymphocyte subsets. Infectious mononucleosis. CD4−CD8+T cells. DPT cells
Introduction
The authors Liling Chen and Xinyuan Chen should be considered co-first authors and contributed equally to this work. * Xiangyang Lin [email protected] 1
School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
2
Department of Clinical Laboratory, Wenzhou Central Hospital, Wenzhou, China
3
Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Street, OuHai District, Wenzhou 325000, People’s Republic of China
4
Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China
Infectious mononucleosis (IM) is an acute infectious disease caused mainly by Epstein-Barr virus (EBV) infection, and characterized by high fever, sore throat, lymph node enlargement, hepatitis, skin rash, eyelid edema
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