The effect of the proportion of atypical lymphocytes on the immune system of children with infectious mononucleosis

DOI: 10.12201/bmr.202410.00032

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  Abstract: Objective To study the effect of the proportion of atypical lymphocytes on the immune system of children with infectious mononucleosis (IM). Methods 153 children with IM admitted to our hospital from May 2023 to May 2024 were selected as the IM group, and 153 healthy children were selected as the healthy group. The proportion of atypical lymphocytes in both groups was measured, and the relationship between the proportion of atypical lymphocytes and the EB virus load in IM patients was analyzed. Detect and compare the expression levels of two sets of immune system indicators complement C3, C4, CD19+cells, T lymphocyte subsets, immunoglobulin (Ig) A, IgG, IgM, Analyze the relationship between the proportion of atypical lymphocytes and immune system indicators, and evaluate the degree of immune system disorder in children with IM based on the difference between T lymphocyte subsets and normal children. Divide them into severe immune disorder group and non severe immune disorder group. Analyze the clinical characteristics of children with severe immune disorder and compare the differences in the proportion of atypical lymphocytes. Results Compared with the healthy group, the proportion of atypical lymphocytes in the IM group 16.56 ± 1.34 (%) vs 1.97 ± 0.23 (%) increased (P<0.05). Pearsons test showed a positive correlation between the proportion of atypical lymphocytes and the EB virus load in children with IM (r=0.504, P<0.05). Compared with the healthy group, the IM group had C3 1.13 ± 0.16 (g/L) vs 1.02 ± 0.14 (g/L), C4 0.31 ± 0.04 (g/L) vs 0.28 ± 0.03 (g/L), CD8+T cells 53.24 ± 5.98 (%) vs 25.46 ± 2.31 (%), IgA 11.32 ± 1.54 (g/L) vs 8.56 ± 1.00 (g/L), IgG 1.58 ± 0.21 (g/L) vs 1.02 ± 0.14 (g/L), and IgM 1.54 ± 0.23 (g/L). The levels of CD4+T cells 20.13 ± 2.43 (%) vs 37.86 ± 4.37 (%), CD4+/CD8+0.45 ± 0.05 vs 1.52 ± 0.26, and CD19+cells 6.23 ± 0.89 (%) vs 15.46 ± 2.31 (%) increased and decreased (P<0.05). Compared with children in the non severe immune disorder group, children in the severe immune disorder group have a longer fever course, are more prone to symptoms of pharyngitis and cervical lymph node enlargement, a higher EB virus load, a higher proportion of atypical lymphocytes, and more significant abnormalities in immune system indicators (P<0.05). In pediatric IM, the proportion of atypical lymphocytes is not related to complement C3 and C4 (r=0.088, 0.045, P>0.05), but negatively correlated with CD4+cells, CD4+/CD8+, and CD19+cells (r=-0.406, -0.631, -0.397, P<0.05), and positively correlated with CD8+T cells, IgA, IgG, and IgM (r=0.454, 0.436, 0.440, 0.476, P<0.05). The increased proportion of atypical lymphocytes is a risk factor for the degree of immune system disorder in children with IM OR (95% CI)=5.453 (3.452-10.988), P<0.05. The AUC for diagnosing immune system disorders in children with IM using the proportion of atypical lymphocytes is 0.918, with a 95% CI of 0.876 to 0.961. The optimal diagnostic efficacy is achieved when the cut off value is 16.00%, with a sensitivity of 89.97% and a specificity of 85.64%. Conclusion Children with IM exhibit varying degrees of immune system disorders, with specific immune disorders being the main cause. The degree of disorder is related to an increase in the proportion of atypical lymphocytes, which can serve as a reference indicator for early diagnosis of immune disorders in IM patients.

  Key words: Children with infectious mononucleosis; The proportion of atypical lymphocytes; Cellular immunity; Humoral immunity; Immune system disorders

  Submit time: 12 October 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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