Infectious Mononucleosis in Turkish Children
Ali Bülent Cengiz1, Öge Çultu-Kantaroğlu2, Gülten Seçmeer1, Mehmet Ceyhan1,
Ateş Kara1, Aytemiz Gürgey3
Units of 1Infectious Diseases, and 3Hematology, Department of Pediatrics, Hacettepe University Faculty of Medicine,
Ankara, and 2 Siverek State Hospital, Şanlıurfa, Turkey
The aim of this study was to analyze the demographic, clinical and
laboratory characteristics and prognoses of children diagnosed with infectious
mononucleosis (IM). The demographic features, referral complaints, clinical
and laboratory findings, follow-up, and prognoses of 44 patients diagnosed
with IM between January 2000 and June 2006 at the Infectious Diseases
Department of Hacettepe University İhsan Doğramacı Children’s Hospital
were analyzed retrospectively. The children suspected of IM based on clinical
findings and whose diagnoses were proven by serological tests were enrolled
in the study. In addition, the patients were divided into four groups –namely,
age 0-4, age 5-8, age 9-12 and age 13-16, and the differences among groups
were investigated in terms of their clinical and laboratory findings. The
patients were aged between 3 months and 16 years. The median age was
4, and 56.8% of patients were below age 5. The male/female ratio was 1.6.
No statistically significant variation was observed in the seasonal distribution
of patients (p=0.131). The most common referral complaints were swollen
cervical lymph nodes or swollen neck (68.1%), followed by fever (43.1%) and
sore throat (25%). Lymphadenopathy (79.5%), tonsillopharyngitis (72.7%),
splenomegaly (34%), and hepatomegaly (25%) were the most common physical
examination findings. Leukocyte count was normal in 68.3% of the cases.
Leukocytosis was detected in 29.5% of the patients, and leukopenia in 2.2%.
Lymphocytosis was detected in 44.7% of patients. Downey cell was detected
in the peripheral blood smear of 23.6% of patients, and thrombocytopenia in
11.3%. Elevated alanine aminotransferase and aspartate aminotransferase levels
were detected in 61.9% and 90.4% of patients who were investigated for these
parameters, respectively. The clinical, hematological and biochemical findings
of patients did not vary significantly among age groups (p>0.05). Only one
complication (hemophagocytic syndrome) was observed in one patient.