Clinical characteristics of 131 cases of infectious mononucleosis in pediatric patients and analysis of the risk factors for liver injury

HU Yu-ting; ZHENG Wei; JIANG Mi-zu

doi:10.19538/j.ek2025040611

Abstract：Objective To explore the general clinical characteristics and risk factors for liver injury in children with infectiousmononucleosis(IM),and summarize the clinical experience in diagnosis and treatment.Methods Retros-pective analysis of 131 cases of children with IM was performed,who were hospitalized in Children's Hospital Affiliated to Zhejiang University School of Medicine from July2020 to August 2021.Clinical data,including gender,age,course of disease,clinical manifestations,laboratory examination,imaging examination and disease outcome,were collected.Results Among 131 children with IM,76.3％(100/131)were considered to have liver injury(ALT＞40 U/L).Compared with normal liver injury group,the percentage of hepatomegaly(38.7％vs.64％,P=0.013)and splenomegaly(41.9％vs.75％,P=0.001)was significantly increased in the liver injury group,and so were age[(4.0±2.1)vs.(5.4±3.2)](P=0.012),median disease duration(12 d vs.19 d,P=0.001),hemoglobin[(119.94±13.99)g/L vs.(124.55±10.34)g/L](P=0.008),abnormal lymphocyte ratio(2％vs.6％,P=0.001),and EBV DNA copy number(0 vs.2.7×106copies/L,P=0.015).Logistic regression analysis results showed that age(OR 1.323;95％CI 1.046-1.675,P=0.02),female(OR 3.225,95％CI 1.178-8.833,P=0.023)and abnormal lymphocyte ratio(OR 1.216,95％CI 1.054-1.402,P=0.007)were high-risk factors for IM complicated with liver injury.Conclusion The clinical characteristics of children with IM are complex and changeable.Liver injury of IM is related to gender,age and increase in abnormal lymphocyte rate.The understanding of clinical features of IM in children and the risk factors for liver injury is improved.