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eISSN: 2300-8660
ISSN: 0031-3939
Pediatria Polska - Polish Journal of Paediatrics
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SCImago Journal & Country Rank
1/2023
vol. 98
 
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Artykuł oryginalny

The concentration of IL-6, TNF-α, s-ICAM-1, and EBV DNA load – predictive factors of hepatological complications in children with infectious mononucleosis. A pilot study

Justyna Moppert
1, 2
,
Małgorzata Pawłowska
1, 2
,
Krzysztof Domagalski
3
,
Aleksandra Szwed-Kowalska
4

  1. Department of Paediatrics, Infectious Diseases and Hepatology, Voivodeship Infectious Observation Hospital, Bydgoszcz, Poland
  2. Department of Infectious Diseases and Hepatology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
  3. Department of Immunology, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Torun, Poland
  4. Department of Laboratory Diagnostics, Tadeusz Browicz Provincial Hospital for Infectious Diseases and Observation, Bydgoszcz, Poland
Pediatr Pol 2023; 98 (1): 43-51
Data publikacji online: 2023/03/24
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Introduction
The aim of the study was to assess the relationship between the concentration of pro-inflammatory cytokines such as interleukin 6 (IL-6), tumour necrosis factor α (TNF-α), soluble intercellular adhesion molecule 1 (s-ICAM-1), and Epstein-Barr virus (EBV) DNA viraemia in children with infectious mononucleosis and hepatitis.

Material and methods
The Epstein-Barr virus DNA load in the plasma of 36 immunocompetent patients aged 2.5–18 years with a symptomatic (sore throat, cervical lymph node enlargement, fatigue, and fever), antibody-confirmed EBV primary infection was assessed using a quantitative real-time polymerase chain reaction assay. The concentration of IL-6, s-ICAM-1, and TNF-α in serum was determined using enzyme-linked immunosorbent assay tests.

Results
In a group of patients with infectious mononucleosis caused by EBV and viraemia > 3.5 log10 copies/ml, shorter duration of symptoms, and higher serum levels of s-ICAM-1 and C-reactive protein (CRP) were confirmed. In group of children with EBV hepatitis and CRP > 5 mg/l, levels of s-ICAM-1, γ-glutamyl transpeptidase activity, count of total white blood cells and lymphocytes, and EBV DNA load were significantly higher than in patients with CRP < 5 mg/l. Among patients with EBV hepatitis the increase of s-ICAM-1 concentration correlated with the increase of IL-6 and TNF-α serum levels.

Conclusions
The results suggest a higher risk of cholestatic complications in children with elevated CRP level. They indicate that EBV DNA viraemia in conjunction with an s-ICAM-1, IL-6, and TNF-α assessment may be helpful in selecting patients requiring hospitalization.