Abstract
BackgroundInfectious mononucleosis, a common disease in children and young adults, is often accompanied by elevated transaminase levels and rarely, liver failure. This study aimed to determine whether adenosine deaminase is a marker of severity in children with infectious mononucleosis, especially those with elevated alanine transaminase levels.MethodsThis case-control study was conducted at the Children’s Hospital of Soochow University. A total of 104 children with infectious mononucleosis and 50 controls with other acute infections and fever, tonsillitis, or lymphadenitis, were enrolled in the study. Among the 104 children with infectious mononucleosis, 54 had normal alanine transaminase levels and 50 had elevated alanine transaminase levels. The children’s clinical and laboratory data were analyzed to assess the diagnostic value of adenosine deaminase in the three groups.ResultsThe adenosine deaminase level in the infectious mononucleosis group was significantly higher than that in the control group (P < 0.001). The adenosine deaminase levels were highly correlated with lymphocyte count, CD3+CD8+ T cells (%), CD4+/CD8+ ratio, and CD3−CD19+ (%) (r > 0.7, P < 0.01). The sensitivity and specificity of adenosine deaminase in predicting children with infectious mononucleosis were 97.1% and 94.0%, respectively. Furthermore, multivariate regression analysis revealed that adenosine deaminase level was a risk factor for elevated alanine transaminase in children with infectious mononucleosis.ConclusionsAdenosine deaminase may be a marker of the severity of infectious mononucleosis in children, and a predictor of elevated alanine transaminase in children with infectious mononucleosis.
Highlights
Infectious mononucleosis, a common disease in children and young adults, is often accompanied by elevated transaminase levels and rarely, liver failure
The aim of this study was to explore the pathophysiology of Adenosine deaminase (ADA) in children with Infectious mononucleosis (IM) and concurrently elevated Alanine aminotransferase (ALT), to assess whether ADA measurement is useful for assisting clinicians in the timely diagnosis of IM and judgment of disease severity
Clinical characteristics of the infectious mononucleosis group and the control group A total of 104 patients with IM and 50 control children with acute infectious diseases were enrolled in the study
Summary
Infectious mononucleosis, a common disease in children and young adults, is often accompanied by elevated transaminase levels and rarely, liver failure. This study aimed to determine whether adenosine deaminase is a marker of severity in children with infectious mononucleosis, especially those with elevated alanine transaminase levels. Infectious mononucleosis (IM) is caused by acute Epstein-Barr virus (EBV) infection and presents with a classical triad of fever, pharyngitis, and lymphadenopathy [1]. It occurs mostly in children, adolescents, and young adults. There are rare cases where severe hepatitis or acute hepatic failure develop [6, 7]
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