Abstract:

Objective To analyze virological features of Epstein-Barr virus associated hemophagocytic lymphohistiocytosis in children cases.Methods The patients including 26 children with hemophagocytic lymphohistiocytosis(HLH) and 23 children with infectious mononucleosis(IM).EBV-DNA loads in sera were detected by real-time PCR assay with a commercial kit.Four antibodies,including EBV-IgG/M anti-VCA,EBV-IgG anti-EA,EBV-IgG anti-NA,were detected in sera of HLH cases.Results Seven HLH cases with positive of EBV-DNA in sera were diagnosed as Epstein-Barr virus associated hemophagocytic lymphohistiocytosis(EBV-HLH).The mean EBV-DNA loads in sera of patients with EBV-HLH were(4.586±0.107)×10⁷ copies/mL.Of 7 EBV-HLH, there were 3 primary EBV infections(EBV-IgG anti-NA negative) and 4 reactivated or past EBV infections(EBV-IgG anti-NA positive).All IM cases were positive of EBV-DNA in sera and mean EBV-DNA loads were((6.865±)0.305)×10³ copies/mL.There were significant differences of EBV-DNA loads in sera of patients between EBV-HLH and IM(P=0.000).Conclusion EBV-HLH may occur in different stages of EBV infection.Detection of EBV-DNA in sera by real-time PCR was more practical in diagnosing EBV-HLH than antibody detection.There were significant differences of EBV-DNA loads in sera of patients between EBV-HLH and IM.

Key words: hemophagocytic lymphohistiocytosis, infectious mononucleosis, Epstein-Barr virus, real-time PCR