CLINICAL-MORPHOLOGICAL FEATURES OF LIVER CHANGES IN CHILDREN WITH MONO- AND MIXED-ASSOCIATED TYPES OF INFECTIOUS MONONUCLEOSIS

Authors:

Abstract:

This article considers the clinical features of course of mono- and mixed-associated infectious mononucleosis in 60 patients with and without liver lesions. It was established that symptoms duration of infectious mononucleosis in patients with mixed-associated type were significant longer compared to mono-variant. The similar significant deviation was detected in laboratory tests in patients with mixed-associated infectious mononucleosis. The tendency to detection morphometric and echoacoustic changes of the liver, using ultrasound technique, was noted in the same group of patients. Were established clinical independent predictors of liver lesions in patients with infectious mononucleosis as: concomitant anemia, female sex, age>10 years. During scientific studies morphological changes of the liver in patient with infectious mononucleosis were described with typical signs such as: moderate lymphohistiocytic infiltration, hepatocyte protein dystrophy, moderate manifestations of coagulation necrosis of centrilobular hepatocytes, endothelial desquamation and moderate manifestations of intraductal cholestasis. The presence of EBV-virus was confirmed by immunohistochemistry essay.

Keywords:

infectious mononucleosis children hepatitis herpes infection

References:

1. Antonova MV, Kashuba EA, Drozdova TG, Lyubimtseva OA, Hanipova LV, Ogoshkova NV, Chekhova YuS. Differentsialno-diagnosticheskie aspekty infektsionnogo mononukleoza Epshtejna-Barr virusnoy etiologii u detey s pozitsii dlitelnosti infitsirovaniya. Bulletin of the Ural Medical Academic Science, 2017;14 (2), 171–181. [In Russian]
2. Kolyada TI, Kozko VM, Merkulova NF, Belkina EO, Kolyada ON. Kliniko-imunologichni paraleli tjazhkogo stupenya infektsiynogo mononukleozu z osoblyvostyamy imunnoyi vidpovidi. Infektsiyni khvoroby, (1). 2013. https://doi.org/10.11603/1681-2727.2007.1.1008 [In Ukrainian]
3. Nezgoda II, Bobruk SV. Kliniko-laboratorna harakterystyka proyaviv infektsiynogo mononukleozu u ditey - Infektsiyni khvoroby, 2016; (2), 35–39. [In Ukrainian]
4. Bevz TI, Martynyuk GA, Livshits LA, Demchyshyn YM. Laboratory-biochemical features of the course of chronic hepatitis C with polymorphism rs11536889+ 3725G/C of TLR-4 gene. Journal of Education, Health and Sport, 2020; 10(4), 254–261. DOI:http://dx.doi.org/10.12775/JEHS.2020.10.04.028
5. Cherry J, Demmler-Harrison, GJ, Kaplan, SL, Steinbach, WJ & Hotez, PJ. Feiginand Cherry's textbook of pediatric infectious diseases Vol.1 (8th ed.). Philadelphia: Elsiver, 2009.
6. Cisneros-Herreros, JM, & Herrero-Romero, M. Hepatitis due to herpes group viruses. Infectious Diseases and Clinical Microbiology, 2006; 24 (6), 392–7.
7. De Paschale M. Serological diagnosis of Epstein-Barr virus infection: Problems and solutions World J. Virol. – 2012; 1: 31–43.
8. Farukhi S N, & Fox J C. The role of ultrasound in the management and diagnosis of infectious mononucleosis. Critical ultrasound journal, 2014; 6 (1), 4. https://doi.org/10.1186/2036-7902-6-4.
9. Gulley, ML, & Tang, W. Laboratory assays for Epstein-Barr virus related disease. The Journal of molecular diagnostics: JMD, 2008; 10 (4), 279–292.. https://doi.org/10.2353/jmoldx.2008.080023
10. Gulley, ML & Tang, W. Using Epstein-Barr viral load assays to diagnose, monitor, and prevent posttransplant lymphoproliferative disorder. Clin Microbiol Rev. 2010; 23, 350–366. doi:10.1128 / CMR.00006-09.
11. Jabłońska A, Studzińska M, Szenborn L, Wiśniewska-Ligier M, Karlikowska-Skwarnik M, Gęsicki T, & Paradowska E. TLR4 896A/G and TLR9 1174G/A polymorphisms are associated with the risk of infectious mononucleosis. Scientific reports, 2020; 10(1), 13154. https://doi.org/10.1038/s41598-020-70129-4.
12. Kang M J, Kim T H, Shim K N, Jung S A, Cho, M. S., Yoo, K., & Chung, K. W. Infectious mononucleosis hepatitis in young adults: two case reports. The Korean journal of internal medicine, 2009; 24(4), 381–387. https://doi.org/10.3904/kjim.2009.24.4.381.
13. Wang Y, Li J, Ren Y Y, & Zhao H. The levels of liver enzymes and atypical lymphocytes are higher in youth patients with infectious mononucleosis than in preschool children. Clinical and molecular hepatology, 2013; 19(4), 382–388. https://doi.org/10.3350/cmh.2013.19.4.382.
14. Wu Y, Ma S, Zhang L, Zu D, Gu F, Ding X, & Zhang L. Clinical manifestations and laboratory results of 61 children with infectious mononucleosis. The Journal of international medical research, 2020; 48(10), 300060520924550. https://doi.org/10.1177/0300060520924550.
15. Yang, Y, & Gao, F. Clinical characteristics of primary and reactivated Epstein-Barr virus infection in children. Journal of Medical Virology, 2020; 92 (12), 3709–3716.

Publication:

«World of Medicine and Biology» Vol. 17 No. 77 (2021) , с. 137-142
УДК 616.988.55-053.2-36.002-091.8

DOI:

https://doi.org/10.26724/2079-8334-2021-3-77-137-142