Clinical and immunological differences of infectious mononucleosis in children with acute and prolonged course of the disease
DOI:
https://doi.org/10.15574/PP.2025.3(103).108114Keywords:
children, infectious mononucleosis, immunityAbstract
The basis for conducting the study was the absence in the scientific literature of works devoted to the study of clinical and immunological differences of infectious mononucleosis (IM) in children with an acute and protracted course of the disease.
The aim - to determine the clinical and immunological differences of IM in children with acute and prolonged courses in order to improve therapy and rehabilitation of patients.
Materials and methods. A total of 102 children were under clinical and laboratory-instrumental supervision, of which 65 children (group 1) had acute IM, and 37 (group 2) had a prolonged course.
Results. The severity of lymphoproliferative and hepatosplenic syndromes at the onset of IM can be used as one of the criteria for the probable development of a prolonged course of the disease. The formation of a protracted course is accompanied by a decrease in the content of CD3 less than 50%; CD4 less than 31% and CD8 less than 15%, as well as an increase in the levels of interleukin 1 (IL1) over 20.0 pg/ml (3.5 times more often compared to the group 1), tumor necrosis factor α (TNFα) up to 20.0 pg/ml (1.9 times more often) and a very high level of interleukin 4 (IL4) - over 30.1 pg/ml. Patients of the group 2 were characterized by increased CD22 levels, low levels of immunoglobulins (Ig) IgA, IgM (less than 1.1 g/l), and IgG (less than 10.0 g/l).
Conclusions. Indicators of cellular and humoral immunity influence the course of IM. The formation of the acute course of IM in children is accompanied by activation of both cellular and humoral immunity at the onset of the disease. The prolonged course of IM is characterized by depression of the T-cell link of immunity, as well as inhibition of antibody genesis. The prolonged course of the disease is formed against the background of weak activation of pro-inflammatory interleukins (IL1, TNFα) and significant - anti-inflammatory IL4.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
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