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Clinical characteristics of Epstein-Barr virus infection detected by polymerase chain reaction in children less than 15 years old

Korean Journal of Pediatrics 2008;51(11):1191-1197.
Published online November 15, 2008.
Clinical characteristics of Epstein-Barr virus infection detected by polymerase chain reaction in children less than 15 years old
Jong-In Na1, Ok Lan Kim1, Do-kyoung Seoung1, Seong-Taek Yoo1, Chang Woo Lee1, Doo-Young Choi1, Yeon-Kyun Oh1, Ji-Hyun Cho2, Jong-Duck Kim2
1Department of Pediatrics, College of Medicine, Wonkwang University, Iksan, Korea
2Department of Clinical Laboratory Medicine, College of Medicine, Wonkwang University, Iksan, Korea
15세 이하의 어린이에서 중합효소 연쇄반응으로 검출된 Epstein-Barr 바이러스 감염의 임상적 특성
나종인1, 김옥란1, 성도경1, 유승택1, 이창우1, 최두영1, 오연균1, 조지현2, 김종덕2
1원광대학교 의과대학 소아과학교실
2원광대학교 의과대학 진단검사의학교실
Correspondence: 
Jong-Duck Kim, Email: kjd20104@wonkwang.ac.kr
Abstract
Purpose
: Previously, Epstein-Barr virus (EBV) infection was diagnosed by serological examination; currently, many EBV antigen detection methods have been developed and applied clinically for diagnosing EBV infection. To delineate the clinical characteristics of EBV infection, clinical and laboratory findings were evaluated for patients who tested positive in EBV polymerase chain reaction (PCR).
Methods
: EBV PCR was conducted in 352 patients admitted to the pediatric ward from January 2004 to December 2006, with more than 2 clinical signs such as fever (≥37.5℃), exudative throat infection, lymphadenopathy, hepatitis of unknown etiology, and splenomegaly. The EBV viral gene was detected by PCR in 115 patients (32%), and the clinical characteristics of these patients were evaluated. Laboratory findings such as leukocytosis, thrombocytopenia, atypical lymphocyte, and alteration in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in peripheral blood were examined. The EBV-specific immunoglobulin M antibody (EBV-IgM Ab) was also tested.
Results
: Most of the children were younger than 8 years (89%), and the male to female ratio was 1.3:1. Exudative throat infection and fever (≥37.5℃) were observed in all patients. Cervical lymph node enlargement was seen in 36 patients (31 %); leukocytosis (WBC≥10,000/mm3), in 54 patients (47%); and atypical lymphocyte (≥20%), in 28 patients (24%). EBV-IgM Ab was positive in 33 patients (29%). The younger patients had higher ALT levels and higher incidence of positive EBV-IgM Ab than the older patients.
Conclusion
: The cumulative number of patients diagnosed to have EBV infection by PCR increased markedly for those under 8 years. ALT was higher and EBV-IgM Ab was detected more in younger patients with EBV infection.
Key Words: Epstein-Barr virus infection, Polymerase chain reaction


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