title: Real-time polymerase chain reaction for diagnosing infectious mononucleosis in pediatric patients: A systematic review and meta-analysis.
abstract: In this meta-analysis, we evaluated the diagnostic role of Epstein-Barr virus deoxyribonucleic acid detection and quantitation in the serum of pediatric and young adult patients with infectious mononucleosis. The primary outcome of this meta-analysis was the sensitivity and specificity of Epstein-Barr virus (EBV) deoxyribonucleic acid (DNA) detection and quantitation using polymerase chain reaction (PCR). A systematic review and meta-analysis was performed by searching for articles that were published through September 24, 2014 in the following databases: Medline, Cochrane, EMBASE, and Google Scholar. The following keywords were used for the search: "Epstein-Barr virus," "infectious mononucleosis," "children/young adults/infant/pediatric," and "polymerase chain reaction or PCR." Three were included in this analysis. We found that for detection by PCR, the pooled sensitivity for detecting EBV DNA was 77% (95%CI, 66-86%) and the pooled specificity for was 98% (95%CI, 93-100%). Our findings indicate that this PCR-based assay has high specificity and good sensitivity for detecting of EBV DNA, indicating it may useful for identifying patients with infectious mononucleosis. This assay may also be helpful to identify young athletic patients or highly physically active pediatric patients who are at risk for a splenic rupture due to acute infectious mononucleosis.
authors.affiliation: Department of Hematology, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Sha-Yi
authors.initials: SY
authors.lastname: Jiang
authors.affiliation: Department of Hematology, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Jing-Wei
authors.initials: JW
authors.lastname: Yang
authors.affiliation: Department of Hematology, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Jing-Bo
authors.initials: JB
authors.lastname: Shao
authors.affiliation: Department of Hematology, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Xue-Lian
authors.initials: XL
authors.lastname: Liao
authors.affiliation: Department of Hematology, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Zheng-Hua
authors.initials: ZH
authors.lastname: Lu
authors.affiliation: Department of Hematology, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007244:Infectious Mononucleosis / Q000175:diagnosis*; D008297:Male; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D019562:Viral Load / Q000379:methods; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: infectious mononucleosis; meta-analysis; pediatric; polymerase chain reaction