title: [Clinical and laboratory characteristics of chronic active Epstein-Barr virus infection in children].
abstract: OBJECTIVE
  To study the clinical and laboratory characteristics of chronic active Epstein-Barr virus (EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV.
  
  
  METHODS
  The clinical data of 13 children with CAEBV, as well as 15 cases of acute EBV infection (AEBV) as controls, were analyzed, including clinical manifestations, EBV antibodies, EBV DNA, and peripheral blood lymphocyte subsets.
  
  
  RESULTS
  Both groups of patients had infectious mononucleosis-like symptoms such as fever, hepatomegaly, splenomegaly, and lymphadenectasis, but CAEBV patients had a longer course of disease and continuous and recurrent symptoms. Compared with the AEBV group, the CAEBV group had a significantly higher EBV DNA load in peripheral blood (P<0.05), a significantly higher VCA-IgG titer (P<0.05), and significantly lower numbers of white blood cells, lymphocytes, B cells, total T cells, CD4+ T cells, and CD8+ T cells in peripheral blood (P<0.05). Among 13 CAEBV patients followed up, 8 cases died, 2 cases showed an improvement, 2 cases had a recurrence, and 1 case was lost to follow-up after being transferred to another hospital. All the AEBV patients were cured and had no recurrence during the one-year follow-up.
  
  
  CONCLUSIONS
  The clinical manifestations of CAEBV vary in children. It is difficult to distinguish CAEBV from AEBV early. More attention should be paid to CAEBV because of its severe complications, poor prognosis, and high mortality. Measurement of EBV DNA load, VCA-IgG titer, and lymphocyte subsets in peripheral blood may be helpful in the diagnosis and differential diagnosis of CAEBV.
authors.affiliation: Department of Hematology, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China. y_m_tang@zju.edu.cn.
authors.forename: Jun-Qing
authors.initials: JQ
authors.lastname: Mao
authors.forename: Shi-Long
authors.initials: SL
authors.lastname: Yang
authors.forename: Hua
authors.initials: H
authors.lastname: Song
authors.forename: Fen-Ying
authors.initials: FY
authors.lastname: Zhao
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Xu
authors.forename: Min-Er
authors.initials: ME
authors.lastname: Gu
authors.forename: Yong-Min
authors.initials: YM
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D016131:Lymphocyte Subsets / Q000276:immunology; D008297:Male