Value of plasma EBV DNA load in diagnosis of EBV associated hemophagocytic lymphohistocytosis in children
Objective To detect the plasma EBV-DNA load in children with EBV related hemophagocytic lymphohisti-ocytosis(EBV-HLH)and non EBV-HLH,and to investigate the diagnostic value of plasma EBV-DNA load in chil-dren with EBV-HLH.Methods We retrospectively collected the clinical data of ebv-hlh patients(January 2019-may 2023)and their age-and gender matched plasma EBV+non HLH patients(January 2021-may 2023)from Henan children's hospital.Quantitative real-time polymerase chain reaction(R-T PCR)was used to measure the EBV-DNA load in the plasma of the patients,and EBV+non HLH patients were used as the control group to draw the ROC curve to analyze the optimal cut-off value of plasma EBV-DNA load in the diagnosis of EBV-HLH in children.Results A total of 55 EBV-HLH patients who met the diagnostic criteria and 220 control patients were enrolled.Rela-tive to the control group,the white blood cell count,hemoglobin level,platelet count,fibrinogen level of EBV-HLH patients were lower than those of non EBV HLH patients(all P＜0.05),and the triglyceride and serum ferritin levels were higher than those of non EBV-HLH patients(all P＜0.05).Patients in the EBV-HLH group had a plasma EBV-DNA load of 982(324,3280)×102 copies/mL,which was significantly higher than the non EBV-HLH group 5.54(5.16,10.72)×102 copies/mL(P＜0.001);The optimal cutoff value of plasma EBV-DNA load for the diag-nosis of EBV-HLH in children is 1.36×104 copies/mL,with an AUC of 0.987(95％ confidence interval:0.974-0.999,P＜0.001),which yielded a sensitivity of 94.90％ and a specificity of 93.40％.Conclusion The plasma EBV-DNA load in children exceeded 1.36×104 copies/mL showing a good sensitivity and specificity for diagnosing EBV-HLH.
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