[An analysis of immunophenotyping of peripheral lymphocytes in adult patients with infectious mononucleosis and chronic active Epstein-Barr virus infection]

Dynamic Distribution and Clinical Value of Peripheral Lymphocyte Subsets in Children with Infectious Mononucleosis

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.

The clinical characteristics and the features of immunophenotype of peripheral lymphocytes of adult onset chronic active Epstein-Barr virus disease at a Tertiary Care Hospital in Beijing

Chronic active Epstein-Barr virus (CAEBV) infection is a rare disease with high mortality. Most of CAEBV patients have been reported from Japan and are pediatric cases.The goal was to describe the clinical characteristics and the immunophenotypic features of peripheral lymphocytes in adult onset CAEBV patients.We retrospectively reviewed and analyzed all adult onset CAEBV cases admitted to Peking Union Medical College Hospital (PUMCH) between 2012 and 2016. Demographic, clinical, laboratory data, and the immunophentyping data of peripheral lymphocytes were collected.There were 28 adult onset CAEBV patients. The median age was 45 (range, 20-81). Most of the patients presented with fever; splenomegaly; lymphadenopathy and hepatitis. Unlike pediatric cases reported, the manifestations of cardiovascular diseases in our patients were pulmonary arterial hypertension, decreased cardiac function and aorta vasculitis. Prevalence of interstitial pneumonitis in our patients were comparatively higher and prevalence of hypersensitivity to mosquito bites were comparatively lower than that reported by Japan. In this study, CAEBV patients had decreased B cell, NK cell, CD4 cell and CD8 cell counts. The prevalence of low level of B cells, NK cells, CD4 cells was relatively higher than reported ever.Chinese adult onset CAEBV patients have different clinical characteristics and are featured by an immunosuppression status as demonstrated by decreased B cell, NK cell, CD4 cell and CD8 cell.