83例传染性单核细胞增多症的实验室检查和并发症

目的 　分析传染性单核细胞增多症 (传单 )患儿的实验室检查与并发症 ,利于减少临床漏诊与误诊。方法　回顾性分析 1 995年 1月～ 2 0 0 2年 1 2月我科收治的83例传单患儿的实验室检查特点和并发症的发生情况。结果 　异型淋巴细胞比例增高见于 89 2 %的病例 ,提示为诊断传单简便有效的筛查手段 ,其增高程度与疾病的病情无关。EBV -VCA -IgM的阳性率为 88 5%对传单诊断有重要意义。 36 9%的病例心肌酶谱升高 ;6 8 1 %的病例血沉增快 ;53 9%的病例C -反应蛋白轻度增高 ;73 5%病例发生于 7岁以下儿童 ,7月份及 9份月为发病高峰 ;并发症发生率 78 3%尤以肝脏损害最常见。其次为肺部感染。结论 　大多数传单呈良性临床经过 ,且多具有较典型的临床表现 ,本病并发症常见且多样 ,可累及多种器官。对EBV -VCA -IgM阴性而临床高度怀疑该病病例可采用EBV -PCR扩增技术协助诊断。提高对本病实验室检查特点和并发症的认识 ,有助于减少临床误诊和漏诊。     

83例传染性单核细胞增多症的实验室检查和并发症

目的 分析传染性单核细胞增多症(传单)患儿的实验室检查与并发症，利于减少临床漏诊与误诊。方法 回顾性分析1995年1月～2002年12月我科收治的83例传单患儿的实验室检查特点和并发症的发生情况。结果 异型淋巴细胞比例增高见于89．2％的病例，提示为诊断传单简便有效的筛查手段，其增高程度与疾病的病情无关。EBV—VCA—IgM的阳性率为88．5％对传单诊断有重要意义。36．9％的病例心肌酶谱升高；68．1％的病例血沉增快；53．9％的病例C—反应蛋白轻度增高；73．5％病例发生于7岁以下儿童，7月份及9份月为发病高峰；并发症发生率78．3％尤以肝脏损害最常见。其次为肺部感染。结论 大多数传单呈良性临床经过，且多具有较典型的临床表现，本病并发症常见且多样，可累及多种器官。对EBV—VCA—IgM阴性而I临床高度怀疑该病病例可采用EBV—PCR扩增技术协助诊断。提高对本病实验室检查特点和并发症的认识，有助于减少，临床误诊和漏诊。     

传染性单核细胞增多症的肾脏损害

传染性单核细胞增多症的肾脏损害南京医科大学附属南京第一医院儿科（２１０００６）孔晓红，顾旦平，潘淮宁，黎书实传染性单核细胞增多症（ＩＭ）由ＥＢ病毒引起，可累及全身各系统，其中肾脏损害较少，为０～１３％，近期刘氏报道为４５．８％，我院于１９８２年１月～...     

儿童传染性单核细胞增多症58例报告

传染性单核细胞增多症尚无特异性疗法,为探讨α-干扰素对本病的治疗效果,现将我院近2年诊断明确的58例患儿总结如下。 临床资料 一、诊断标准 (1)具有发热、咽峡炎、淋巴结肿大及肝、脾肿大等;(2)外周血有一次查见异形淋巴细胞占白细胞总数的10％以上;(3)外周血有一     

传染性单核细胞增多症的临床特征

传染性单核细胞增多症（IM）是儿童常见传染病．现将我院1996年6月～1998年8月咽分泌物EBV－PCR阳性、同时血EBV－VCA－IgM阳性而确诊的96例IM患儿的临床表现,分析如下。临床资料一、一般资料：男47例,女49例;发病年龄：8mo～12a,其中<1aZ例,1～3a26例,～5a25例,～7a17例．～9a18例,～12as例。＜5a53／96例（55．2％）．≥5a43／96例（44．2％）。二、临床表现1．症状：发热91例（94．8％）．上呼吸道感染68例（70．8％）．其中鼻塞25例（26．1％）．睑肿40例（41．7％）,咽痛38例（39．6％）,颈部包块25例（26．0％）．…     

传染性单核细胞增多症实验诊断初探

对５６例怀疑为传染性单核细胞增多症（ＩＭ）患儿进行实验性检测。确诊的１４例中外周血异形淋巴细胞〉１０％者３例，嗜异性凝集试验阳性９例，但抗ＶＣＡ－ＩｇＭ阳性为１２例；因此测定ＥＢＶ抗体才能真正提高诊断ＩＭ的水平，而嗜异性凝集试验阳性率低，在非ＩＭ疾病中假阳性率高，特异性不强，作为ＩＭ的诊断指标值得商榷。     

传染性单核细胞增多症伴心肌损害59例报告

传染性单核细胞增多症(IM)是儿童常见病毒性传染病,常以发热、咽炎、外周淋巴结及肝脾肿大 等为主要表现,而有关心脏损害的报告较少。我院对1997年7月～1998年1月IM患儿59例进行心肌酶谱及心电图检查,现报告如下。 临床资料 一、对象 选符合以下3项诊断为IM的患儿,共59例:①发热、咽炎、外周淋巴结肿大、肝脾肿     

Cardiac complications and immunophenotypic profile of infectious mononucleosis syndrome in children

Objective  

To investigate cardiac complications in infectious mononucleosis patients and to associate them with biochemical and immunological parameters, as well as with spleen ultrasound findings.     

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??Objective To investigate clinical characteristics and laboratory feature of Epstein-Barr Virus??EBV?? infection and infectous mononucleosis in children. Method A retrospective study was conducted in 108 hospitalized patients who were enrolled from Jan 2010 to May 2011.Among them 77 patients were diagnosed with IM. Results In our investigation most of the IM was seen in preschool children??41.6%??and in young children??36.4%?? . Eyelid edema was common clinical manifestations of IM??the percentage of which was higher than enlarged spleen and rash in IM group.Increased ratio of atypical lymphocytes ??≥10%?? was seen in only 33.8% of the IM patients.The EBV-DNA level in plasm of IM patients was in the range of 1.04 × 103??2.88 × 105 copies/mL??with a mean value of 7.18 × 104 copies/mL. All of 3 cases of EBV-HLH in our study were negative in sera of anti-VCA-IgM?? but were positive of EBV-DNA in plasma and mean EBV-DNA loads were 2.71 × 107 copies/mL. Conclusion In our observation eyelid edema has the same diagnostic value as the other typical manifections in IM.The clinical significance of atypical lymphocyte in the diagnosis of IM??especially in infants and young children??needs to be further confirmed.EBV-DNA copy in peripheral blood seems to be closely related to the active infection of EBV and in EBV-HLH the diagnostic value of detection of EBV-DNA in serum by FQ-PCR should be emphasized.     

Epstein-Barr virus infectious mononucleosis in children. I. Clinical and general laboratory findings

Between 1976 and 1982, 113 children aged 6 months to 16 years with documented Epstein-Barr virus-induced infectious mononucleosis were studied prospectively, and in most instances serially. An unexpected finding was the large number of young children, less than 4 years old, with this disease. Children with infectious mononucleosis, in particular the very young, tended to have more rashes, significant neutropenia, abdominal pain (older children only), and possible hepatosplenomegaly than have been reported in adult patients. The intensity of the characteristic relative atypical lymphocytosis found in peripheral blood was age-related; it was less in the very young. Findings of failure to thrive, otitis media, and episodes of recurrent tonsillopharyngitis appeared to be unique or more closely associated with childhood disease. Complications such as thrombocytopenia with hemorrhagic manifestations, significant airway obstruction, and neurologic problems occurred more frequently whereas jaundice occurred less frequently than noted in adult patients. Six children, all less than 4 years old, developed pneumonia during the disease course. The increased availability of Epstein-Barr virus-specific testing should continue to expand our knowledge of this disease in children of all ages.     

儿童传染性单核细胞增多症临床特征及T细胞亚群分析

目的探讨儿童传染性单核细胞增多症(IM)的临床特征和T细胞亚群变化规律,分析其临床意义。方法回顾性分析2015年1月-2016年12月收治的59例IM患儿的临床资料,比较患儿初诊及治疗后的临床特征和实验室检测指标。结果初诊患儿临床表现以发热(93.2%)、淋巴结肿大(62.7%)和咽峡炎(52.5%)多见;实验室检查以外周血WBC1010~9/L(84.7%)、外周血异型淋巴细胞10%(81.3%)和ALT升高(52.5%)多见;与初诊时比较,治疗后淋巴结肿大阳性率差异无显著性(P0.05),其他项目差异均具有显著性(P0.05)。初诊患儿DNT细胞、CD3~+T细胞、CD3~+CD8~+T细胞百分比均显著高于对照组(P0.01),CD3~+CD4~+T细胞百分比显著低于对照组(P0.01)。治疗后患儿DNT细胞、CD3~+T细胞、CD3~+CD4~+T细胞、CD3~+CD8~+T细胞与正常对照组相比差异无显著性(P0.05)。结论 IM起病时症状多样,存在明显的免疫失衡,监测患儿不同时期临床特点及T细胞亚群变化,能够为IM患儿临床免疫治疗提供理论依据。     

Acute complications of Epstein-Barr virus infectious mononucleosis

Infectious mononucleosis caused by Epstein-Barr virus (EBV) usually resolves over a period of weeks or months without sequelae but may occasionally be complicated by a wide variety of neurologic, hematologic, hepatic, respiratory, and psychological complications. The strength of association of EBV with many of these complications remains based on scattered case reports, often using unsophisticated diagnostic tests, and the evidence for causation in many instances is unconvincing. There is little benefit of antiviral treatment of uncomplicated or complicated infectious mononucleosis. Corticosteroids may have a role in hastening resolution of some complications, especially upper airway obstruction and possibly immune-mediated anemia and thrombocytopenia, but should be used judiciously.     

儿童传染性单核细胞增多症70例临床分析

目的 分析儿童传染性单核细胞增多症(IM)的发病趋势、临床特征、并发症的治疗情况及预后.方法 对70例确诊的IM患儿临床资料进行回顾性分析,并对相关的文献进行复习.结果 不伴有多脏器功能损害IM预后良好,伴有多脏器功能损害IM应积极治疗并发症,减少后遗症发生.结论 根据临床表现及外周血常规检查结果给予早期确诊并积极治疗并发症是IM治疗成功的关键.