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OBJECTIVE@#Review and analyze the characteristics of bone marrow cell morphology in patients with Epstein-Barr virus (EBV) infection, and explore the diagnostic value of bone marrow cell morphology for the early identification of EBV infection.@*METHODS@#A total of 33 patients with EBV-DNA positive detection in the First Affiliated Hospital of Guangxi Medical University from January 2018 to May 2021 were collected as the research objects. Bone marrow cell morphology and peripheral blood cell analysis were performed, and the significance in disease diagnosis was analyzed by statistical methods.@*RESULTS@#The sampling satisfaction of 33 patients with EBV infection was 100%. In the clinical diagnosis of all cases, 7 cases were IM, 17 cases were EBV-HLH, 3 cases were lymphoma, 2 cases were EBV-associated lymphoid hyperplasia, and 4 cases were not diagnosed. Among them, 31 patients had active bone marrow hyperplasia or above, 26 patients had active granulocytic hyperplasia or above, 21 patients had active erythroid hyperplasia or above, and 17 cases of megakaryocyte production platelet function decreased. The abnormal components of bone marrow mainly indude atypical lymphocyte cells (33 cases), hemophagocytic cells (22 cases), abnormal histiocyte (10 cases).@*CONCLUSION@#According to the proliferation of granulocytes, erythrocytes and megakaryocytes in the bone marrow, and the emergence of abnormal components such as atypical lymphocytes, hemophagocyte, abnormal histiocyte. Bone marrow cell morphological examination can indicate the possibility of EBV infection, which is certain diagnostic value for early identification of EBV infection.
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Humanos , Células da Medula Óssea , Doenças da Medula Óssea/patologia , China , Infecções por Vírus Epstein-Barr , Herpesvirus Humano 4 , Hiperplasia/patologiaRESUMO
Objective@#To investigate the clinical manifestations, prognosis and gene mutation phenotypes of hemophagocytic lymphohistiocytosis(HLH)in children of our hospital.@*Methods@#The clinical data of 42 patients with HLH from April 2013 to December 2018, and the genetic data of 8 patients with familial HLH(FHL)were collected retrospectively.The age, clinical manifestation, laboratory examination, prognosis and the characteristics of gene mutation phenotype of patients with HLH and FHL were analyzed emphatically.Furthermore, the clinical manifestations and prognosis of patients with HLH were analyzed according to whether EB virus was infected.@*Results@#Among these 42 patients with HLH, the onset age was ranged from 1 month to 13 years old and most of them were younger than 5 years old.The main clinical manifestations included cytopenia, prolonged fever, enlargement of liver and spleen and lymph nodes enlargement and serosal effusion.Laboratory examination showed that lactate dehydrogenas, ferritin, erythrocyte sedimentation rate and triglyceride increased significantly.The survival rate of the group in ferritin exceeding 4 500 μg/L and non-chemotherapy was lower than that of the group of ferritin less than 4 500 μg/L and chemotherapy in clinical prognosis(P<0.05). Ten patients of them survived after chemotherapy, and 2 patients survived for 5 to 6 months after hematopoietic stem cell transplantation in FHL.Patients with EB virus infection were older than those without EB virus infection.They had longer fever duration and higher proportion of lymph nodes enlargement and ferritin more than 4 500 μg/L(P values were 0.01, 0.04, 0.03, 0.03 respectively). However, there was no significant difference in survival time between the two groups.Eight patients had mutations in UNC13D(50.00%), PRF1(25.00%), PRKDC(12.50%)and IL2RG(12.50%)genes respectively, and most of the mutations were complex heterozygous mutations(62.50%). All the mutations were originated from their parents.@*Conclusion@#HLH is characterized by cytopenia, prolonged fever, enlargement of liver and spleen.HLH is more common in children under 5 years old.The clinical manifestations of HLH with EB virus infection are more severe while the prognosis is not statistically significant.The incidence of FHL is higher.There are more UNC13D gene mutations and complex heterozygous mutations.Children with HLH should be detected and treated with standardized therapy as soon as possible.Hematopoietic stem cell transplantation is a good treatment for HLH, especially for FHL patients.
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Objective To investigate the clinical manifestations,prognosis and gene mutation pheno-types of hemophagocytic lymphohistiocytosis(HLH)in children of our hospital. Methods The clinical data of 42 patients with HLH from April 2013 to December 2018,and the genetic data of 8 patients with familial HLH(FHL)were collected retrospectively. The age,clinical manifestation,laboratory examination,prognosis and the characteristics of gene mutation phenotype of patients with HLH and FHL were analyzed emphatical-ly. Furthermore,the clinical manifestations and prognosis of patients with HLH were analyzed according to whether EB virus was infected. Results Among these 42 patients with HLH,the onset age was ranged from 1 month to 13 years old and most of them were younger than 5 years old. The main clinical manifestations in-cluded cytopenia,prolonged fever,enlargement of liver and spleen and lymph nodes enlargement and serosal effusion. Laboratory examination showed that lactate dehydrogenas,ferritin,erythrocyte sedimentation rate and triglyceride increased significantly. The survival rate of the group in ferritin exceeding 4 500 μg/L and non- chemotherapy was lower than that of the group of ferritin less than 4 500 μg/L and chemotherapy in clinical prognosis(P<0. 05). Ten patients of them survived after chemotherapy,and 2 patients survived for 5 to 6 months after hematopoietic stem cell transplantation in FHL. Patients with EB virus infection were older than those without EB virus infection. They had longer fever duration and higher proportion of lymph nodes enlargement and ferritin more than 4 500 μg/L(P values were 0. 01,0. 04,0. 03,0. 03 respectively). Howev-er,there was no significant difference in survival time between the two groups. Eight patients had mutations in UNC13D(50. 00%), PRF1 ( 25. 00%), PRKDC ( 12. 50%) and IL2RG ( 12. 50%) genes respectively, and most of the mutations were complex heterozygous mutations(62. 50%). All the mutations were originated from their parents. Conclusion HLH is characterized by cytopenia,prolonged fever,enlargement of liver and spleen. HLH is more common in children under 5 years old. The clinical manifestations of HLH with EB virus infection are more severe while the prognosis is not statistically significant. The incidence of FHL is higher. There are more UNC13D gene mutations and complex heterozygous mutations. Children with HLH should be detected and treated with standardized therapy as soon as possible. Hematopoietic stem cell transplantation is a good treatment for HLH,especially for FHL patients.
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Objective To investigate the changes and significance of patients′ T lymphocyte subsets with lymphoma and EB virus infection.Methods 57 patients with malignant lymphoma who were admitted to our hospital between January 2015 and January 2017 were divided into A group (with EB infection, n=31) and B group (without EB infection, n=26).The other 30 healthy cases were selected as control group (group C) at the same time.The fasting venous blood of all subjects was collected, and the levels of T lymphocyte subsets were measured by flow cytometry.Results Compared with group C, the levels of CD3+, CD4+ and CD4+/CD8+ in A group and B group were significantly lower while the levels of CD8+ were significantly higher (P<0.05).Compared with B group, the levels of CD3+, CD4+ and CD4+/CD8+ in A group were significantly lower while the levels of CD8+ were significantly higher (P<0.05).Conclusion The levels of T lymphocyte subsets can be used as important indexes to judge the severity of lymphoma.When there is severe T lymphocytes immune dysfunction, EB virus infection should be considered, and timely diagnosis and early treatment should be carried out.
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Objective To observe the clinical efficacy of self made Qinchai Kangdu mixture for treatment of infantile EB virus (EBV) infectious mononucleosis and explore its potential mechanism. Methods A prospective study was conducted. One hundred and twenty children with pediatric EBV infectious mononucleosis and traditional Chinese medicine (TCM) syndrome of flaring heat in Qifen and Yingfen in Wuhan Children Hospital were randomly divided into observation group and control group (each, 60 cases). Conventional western medical treatment was given to the two groups for 7-10 days;the observation group was additionally given Qinchai Kangdu mixture which included the following ingredients:Scutellariae Radix 10 g, Bupleuri Radix 10 g, Artemisiae Annuae Herba 10 g, Forsythiae Fructus 20 g, Arctii Fructus 10 g, Paeoniae Radix Rubra 10 g, Cinnamomi Ramulus 6 g, Moutan Cortex 10 g, Trionycis Carapax 10 g, Isatidis Radix 20 g, Citri Reticulatae Pericarpium 10 g, Glycyrrhizae Radix 10 g, orally, once daily for 7-10 days. The times of returning to normal for clinical symptoms and signs, white blood cell count (WBC), peripheral blood abnormal lymphocyte ratio and the level of alanine aminotransferase (ALT) were observed in the two groups. And the clinical efficacy, changes in score of TCM syndrome and adverse reactions were also investigated in the two groups. Results The total effective rate in the observation group was significantly higher than that in the control group [93.33%(56/60) vs. 76.67%(46/60), P<0.05]. In observation group, the duration of fever (days:6.9±2.3 vs. 7.7±3.4), and the recovery times to normal for body temperature (days:2.9±1.4 vs. 4.8±1.7), angina (days:7.2±3.3 vs. 8.0±3.2), lymph node reduction in size (days: 6.6±2.1 vs. 10.2±2.0), enlarged liver bounce back in size (days: 7.8±1.7 vs. 9.6±2.0), WBC (days:7.22±1.78 vs. 10.67±1.97), peripheral blood abnormal lymphocyte ratio (days:7.24±1.86 vs. 11.15±1.65), and ALT (days:8.44±1.83 vs. 11.43±2.65) were all significantly shorter than those in the control group (all P < 0.05). No adverse reactions occurred in the therapeutic course in the two groups. Conclusions Qinchai Kangdu mixture can effectively improve the clinical symptoms of infantile EBV infectious mononucleosis with TCM syndrome of flaring heat in Qifen and Yingfen. The mixture may also promote the enlarged liver and spleen to contract in size at early stage and peripheral blood abnormal lymphocyte ratio and other laboratory indexes return to normal in time.
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Objective To analyze the clinical correlation between EB virus-induced pharyngitis with gastrointestinal symptoms and mesenteric lymphadenitis in children , and to explore the value of EBV-VCA-IgM dectection and color Doppler ultrasound in the diagnosis of EB virus-induced mesenteric lymphadenitis. Methods 356 children with pharyngitis complicated by gastrointestinal symptoms were prospectively analyzed. 162 patients who had a postive result of EBV-VCA-IgM detection by ELISA were assigned to a study group , while another 194 patients who had a negative result were assigned to a control group. The size , number and blood flow of mesenteric lymph nodes were determined by color Doppler ultrasound in both groups. The data were counted , compared and analyzed. Results 43 children had mesenteric lymphadenitis in the study group , so had 11 in the control group. There was a significant difference between the two groups (P < 0.01). Conclusions Children with pharyngitis complicated by gastrointestinal symptoms may suffer from mesenteric lymphadenitis. ELISA for EBV-VCA-IgM detection and color Doppler ultrasound have certain clinical value in the diagnosis of mesenteric lymphadenitis indcued by EB virus infection.
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0.05). EBV DNA positive were found in gastric mucosa of 40.0% in control group, 73.1 %(19/26) in GC tissue(P