Publication: Retrospective Analysis of Children With Acute (Primer) Ebstein Barr Virus Infection
Abstract
Amaç: Çocukluk çağında akut Ebstein Barr Virus(EBV) enfeksiyonu olan hastaların demografik, klinik, laboratuar özellikleri ve prognozlarının incelenmesi amaçlanmıştır. Hastalar ve Yöntem: Ondokuzmayıs Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Hastanesi'ne 01 Ocak 2005- 01 Ocak 2017 tarihleri arasında başvuran üç ay- 17,5 yaş arası EBV IgM serolojisi (+) olan 1021 hastanın başvuru yakınmaları, klinik ve laboratuar bulguları retrospektif olarak incelendi. Bulgular: Erkek / kız oranı 1,4 olarak tespit edildi. Primer EBV enfeksiyonu cinsiyete göre normal dağılım göstermekteydi (p=0,20). Hastaların ortalama yaşı 6,3 4,2 yıldı ve % 62,2'si beş yaş altındaydı. Başvuruların ilkbahar ve yaz mevsiminde yoğunlaştığı ancak mevsimlere göre dağılım incelendiğinde istatiksel anlamlı bir farklılık olmadığı görüldü (p=0,15). En sık başvuru şikayeti ateşti (% 41,7). Bunu boyunda beze (% 29,2) ve boğaz ağrısı (% 12,7) takip ediyordu. Lökosit sayıları hastaların % 49,5'inde normal, % 47,3'ünde yüksek ve % 3,2'sinde düşüktü. Vakaların % 32,7'sinde anemi, %55,8'inde lenfositoz, % 17,1'inde monositoz, %12,7'sinde lenfomonositoz, % 9,2'sinde nötropeni, % 11,6'sında trombositopeni ve % 39'unda Downey hücresi tespit edildi. Lenfomonositoz saptanan hastaların % 32,8'ine Enfeksiyöz Mononükleoz(EMN) tanısı konuldu. Hastaların yakınmaları, klinik ve laboratuar bulguları cinsiyete göre istatiksel anlamlı farklılık göstermedi (p>0,05). Yaş gruplarına göre boyunda beze şikayetinin ve hematolojik parametrelerin istatiksel anlamlı farklı olduğu tespit edildi (p<0,01). Ateş, boyunda beze ve boğaz ağrısının 2-10 yaş grubu çocuklarda daha fazla olduğu, lökositozun beş yaş altı çocuklarda daha fazla olduğu, lökopeninin >10 yaş çocuklarda daha fazla olduğu ve aneminin iki yaş altı çocuklarda daha fazla olduğu tespit edildi. EBV IgM (+)'liği gösteren hastaların primer EBV enfeksiyonuna ilave hastalıklarla (enfeksiyöz, hematolojik, malignite, kollajen doku hastalığı, karaciğer ve böbrek hastalıkları) da ilişkili olabildiği gösterildi. Hastalardan birine ciddi splenomegali nedeniyle splenektomi yapıldı. Hastalarımızın ikisi solunum arresti nedeniyle, ikisi de yeni tanı Akut Lenfositik Lösemi (ALL) hastalığı ile ex olmuştu. Sonuç: Çocukların başvuru şikayetlerinde, klinik ve laboratuar değerlerinde cinsiyete göre anlamlı bir farklılık saptanmazken, klinik şikayetlerin 2-10 yaş grubunda daha iyi ifade edildiği, beyaz küre değerlerinin <5 yaş grubunda daha yüksek seyrettiği, monositoz ve lenfomonositozun da <5 yaş grubunda daha sık görüldüğü, EMN'un ilave ek hastalıklarla beraber seyredebildiği tespit edilmiştir. Anahtar kelimeler: Çocuk, Enfeksiyöz mononükleoz, Epstein-Barr Virus
Purpose: To evaluate the demographic features, clinical and laboratory findings and prognosis of patients with acute Ebstein Barr Virus (EBV) infection in childhood. Patients and Methods: Application complaints, clinical and laboratory findings of 1021 patients who refered Ondokuzmayıs University Medicine Faculty, Child Health and Illness Hospital between 01 January 2005 and 01 January 2017 and age between three months and 17,5 years, with positive serology of EBV IgM were determined retrospectively. Findings: Male / female ratio was found as 1.4. No statistical significant variation about sexuality (p=0.20). Mean age of patients were 6.3 years and 62.2 % of them were under five years old. The most referral seasons were spring and summer but no statistical significant seasonal variation (p=0.15). The most common complaints were fever (41.7 %), swollen lymph nodes in neck (29.2 %) and sore throat (12.7), respectively. The most common physical examination finding was lymphadenopathy (44.9). Leukocyte count was normal in 52% of the cases, was increased in 45.7% of cases and decreased in 2.3% of cases. Anemia was detected in 32.7% of the cases, lymphocytosis was detected in 55.8% of the cases, monocytosis was detected in 17.1% of the cases, lymphomonocytosis was detected in 12.7% of the cases, neutropenia was detected in 9.2% of the cases, thrombocytopenia was detected in 11.6% of the cases and Downey cells on peripheral blood smear was detected in 39% of the cases. There were no statistical significant differences in sexuality about application complaints, clinical and laboratory findings (p>0.05). We found significant results in hematologic findings and swollen lymph nodes in neck between age groups (p<0.01). Fever, swollen lymph nodes in neck and sore throat were usually seen between 2-10 years groups. Leukocytosis was more often in child under five years old, leucopenia was more often in child older than 10 years old and anemia was more often in child under two years old. Patients with positive serology of EBV IgM have diagnosed with many diseases (such as infectious, hematologic, malignant, collagen tissue disease, hepatic and renal diseases) additional infectious mononucleosis. One patient diagnosed with serious splenomegaly was done splenectomy, two of cases with respiratory arrest and two of cases with new diagnosed Acute Lenphositic Leucemia (ALL) were exitus. Results: There were no statistical differences about application complaints, clinical and laboratory findings of the patients in sexuality. The application complaints were better explained between 2-10 years old. Leukocytosis, monocytosis and lymphomonocytosis were more often in child under five years old. And this study was determined us, many diseases may be together with infectious mononucleosis. Key words: Child, Epstein-Barr virus, Infectious mononucleosis
Purpose: To evaluate the demographic features, clinical and laboratory findings and prognosis of patients with acute Ebstein Barr Virus (EBV) infection in childhood. Patients and Methods: Application complaints, clinical and laboratory findings of 1021 patients who refered Ondokuzmayıs University Medicine Faculty, Child Health and Illness Hospital between 01 January 2005 and 01 January 2017 and age between three months and 17,5 years, with positive serology of EBV IgM were determined retrospectively. Findings: Male / female ratio was found as 1.4. No statistical significant variation about sexuality (p=0.20). Mean age of patients were 6.3 years and 62.2 % of them were under five years old. The most referral seasons were spring and summer but no statistical significant seasonal variation (p=0.15). The most common complaints were fever (41.7 %), swollen lymph nodes in neck (29.2 %) and sore throat (12.7), respectively. The most common physical examination finding was lymphadenopathy (44.9). Leukocyte count was normal in 52% of the cases, was increased in 45.7% of cases and decreased in 2.3% of cases. Anemia was detected in 32.7% of the cases, lymphocytosis was detected in 55.8% of the cases, monocytosis was detected in 17.1% of the cases, lymphomonocytosis was detected in 12.7% of the cases, neutropenia was detected in 9.2% of the cases, thrombocytopenia was detected in 11.6% of the cases and Downey cells on peripheral blood smear was detected in 39% of the cases. There were no statistical significant differences in sexuality about application complaints, clinical and laboratory findings (p>0.05). We found significant results in hematologic findings and swollen lymph nodes in neck between age groups (p<0.01). Fever, swollen lymph nodes in neck and sore throat were usually seen between 2-10 years groups. Leukocytosis was more often in child under five years old, leucopenia was more often in child older than 10 years old and anemia was more often in child under two years old. Patients with positive serology of EBV IgM have diagnosed with many diseases (such as infectious, hematologic, malignant, collagen tissue disease, hepatic and renal diseases) additional infectious mononucleosis. One patient diagnosed with serious splenomegaly was done splenectomy, two of cases with respiratory arrest and two of cases with new diagnosed Acute Lenphositic Leucemia (ALL) were exitus. Results: There were no statistical differences about application complaints, clinical and laboratory findings of the patients in sexuality. The application complaints were better explained between 2-10 years old. Leukocytosis, monocytosis and lymphomonocytosis were more often in child under five years old. And this study was determined us, many diseases may be together with infectious mononucleosis. Key words: Child, Epstein-Barr virus, Infectious mononucleosis
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