ArticleItalian journal of pediatrics2026
Clinical characteristics in hospitalized children with infectious mononucleosis in Shanghai China: a single-center retrospective study.
Article in Italian journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo investigate clinical features and peripheral blood inflammatory markers in children with Epstein-Barr virus (EBV)-induced infectious mononucleosis (IM), analyze their correlation with disease severity, enable early identification of severe cases, and provide a theoretical basis for early clinical intervention.
methodsA retrospective analysis was performed on 156 hospitalized children with EBV-related IM (January 2019-December 2024). EBV nucleic acid was detected via real-time PCR. Patients were grouped by blood EBV-DNA load (positive/negative). Demographics, clinical manifestations, laboratory findings, and liver/spleen/lymph node imaging were collected and analyzed.
resultsAmong 156 pediatric IM patients (mean age 7 years), IM occurred predominantly in spring (28.20%) and autumn (28.21%), with children aged ≥ 7 years identified as the high-risk group. EBV-DNA positivity was higher in summer and winter. EBV-DNA positivity correlated with disease severity, as evidenced by longer hospitalization (9 vs. 7 days, P = 0.038), elevated inflammatory markers (LDH, ALT, AST), coagulation abnormalities (D-dimer; P < 0.05), and altered immune profiles (elevated CD3+CD8+ T cells and reduced NK cells; P < 0.05). Receiver operating characteristic (ROC) analysis identified CD3+ T cells (AUC = 0.664) and D-dimer (AUC = 0.692) as primary predictors biomarkers for IM, with CD8+ T cells, LDH, and ALT as supportive biomarkers. Biomarker combination boosted predictive accuracy (AUC = 0.713, 72.1% sensitivity, 62% specificity), demonstrating key synergistic diagnostic value in EBV pathogenesis.
conclusionEBV infection is prevalent among school-aged children in Shanghai, causing significant cellular and humoral immune dysfunction. Longitudinal monitoring of immunological parameters is crucial. EBV-DNA load is a valuable prognostic biomarker for severe IM; elevated inflammatory markers and immune dysregulation in EBV-DNA-positive children are critical for severity assessment.
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