title: Cytokine profiles as novel diagnostic markers of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in children.
abstract: The aim of this study was to identify specific laboratory indices to distinguish Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children.
  
  
  
  In this prospective study, Th1/Th2 cytokines, including IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ, were analyzed in patients with EBV-HLH or sepsis at the onset of disease by flow cytometry.
  
  
  
  IL-10, IFN-γ, IL-10/IL-6, and IFN-γ/IL-6 were higher and IL-6 was lower in EBV-HLH patients compared to sepsis patient levels. When using the criteria of IL-10 >20.9 pg/mL, IFN-γ >17.9 pg/mL, IL-10/IL-6 >0.5 and IFN-γ/IL-6 >0.7, the sensitivity was 89.8%, 93.2%, 93.2%, and 91.5%, while the specificity was 89.8%, 100%, 94.9%, and 100%, respectively. After treatment of EBV-HLH patients, IL-6, IL-10, TNF-α, and IFN-γ were significantly reduced (IL-6: P<.001; IL-10: P<.001; TNF-α: P=.011; IFN-γ: P<.001).
  
  
  
  This study showed that IFN-γ, IL-10/IL-6, and IFN-γ/IL-6 are novel specific indicators for differential diagnosis of EBV-HLH. Additionally, IL-6, IL-10, TNF-α, and IFN-γ are useful indices for monitoring the effects of treatment on EBV-HLH.
authors.affiliation: Zhejiang Key Laboratory for Neonatal Diseases, Clinical Laboratory, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China.
authors.forename: Xiu-Cui
authors.initials: XC
authors.lastname: Han
authors.affiliation: Zhejiang Key Laboratory for Neonatal Diseases, Clinical Laboratory, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China. Electronic address: yeqingkaoyan@163.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Ye
authors.affiliation: Clinical Laboratory, Hangzhou first people's Hospital, Hangzhou, PR China.
authors.forename: Wei-Ying
authors.initials: WY
authors.lastname: Zhang
authors.affiliation: Zhejiang Key Laboratory for Neonatal Diseases, Clinical Laboratory, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China.
authors.forename: Yong-Min
authors.initials: YM
authors.lastname: Tang
authors.affiliation: Zhejiang Key Laboratory for Neonatal Diseases, Clinical Laboratory, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China.
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Xu
authors.affiliation: College of Medical Technology, Zhejiang Chinese Medical University, Hangzhou, PR China.
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000378:metabolism*; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis*; D005260:Female; D005434:Flow Cytometry; D004854:Herpesvirus 4, Human; D006801:Humans; D007223:Infant; D007378:Interleukins / Q000378:metabolism; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000821:virology; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D015415:Biomarkers; D016207:Cytokines; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha
keywords: Cytokines; EBV-HLH; IFN-γ/Il-6; Il-10/Il-6