High mean platelet volume‑to‑platelet count ratio as a diagnostic maker for increased risk of liver function damage in pediatric patients with infectious mononucleosis in China

Han,Xiucui; Xu,Pengfei; Duan,Xiuzhi; Liu,Yongxia; Zhang,Junfeng; Xu,Hui

doi:10.3892/etm.2019.8104

High mean platelet volume‑to‑platelet count ratio as a diagnostic maker for increased risk of liver function damage in pediatric patients with infectious mononucleosis in China

Authors:
- Xiucui Han
- Pengfei Xu
- Xiuzhi Duan
- Yongxia Liu
- Junfeng Zhang
- Hui Xu
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Affiliations: Zhejiang Key Laboratory for Neonatal Diseases, Clinical Laboratory, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310051, P.R. China, Clinical Laboratory, Zhejiang Hospital, Hangzhou, Zhejiang 310013, P.R. China, Clinical Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China, Clinical Laboratory, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China
Published online on: October 15, 2019 https://doi.org/10.3892/etm.2019.8104
Pages: 4523-4527

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Abstract

The aim of the present study was to provide novel laboratory indexes for infectious mononucleosis (IM) in pediatric patients. In the present prospective study, a total of 141 pediatric patients with IM and 146 healthy subjects were enrolled. The white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HB), platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ‑glutamyl transferase (GGT), uric acid (UA), urea, creatinine, total cholesterol (TC) and triglycerides (TG) in peripheral blood were evaluated. WBC, ALT, AST, GGT, UA, TG, MPV and the MPV/PLT ratio in the patients were significantly higher compared with those in the controls (P<0.01), while RBC, HB, urea, TC, PLT and PDW were significantly lower in the patients (P<0.05 for PDW and P<0.01 for others). Regression analysis under stepwise adjustment indicated that PLT and MPV/PLT were significantly associated with IM (P<0.01). Furthermore, MPV/PLT was positively correlated with ALT, AST, GGT, UA and TC (P≤0.01). In the receiver operating characteristic analysis, a sensitivity of 83.7% and specificity of 76.0% regarding the prediction of IM in pediatric patients using the MPV/PLT ratio was achieved at the cutoff of MPV/PLT(%)=3.42. In conclusion, the MPV/PLT ratio may be a novel diagnostic indicator for pediatric IM and indirectly predict damage to liver function.

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1	Young LS and Rickinson AB: Epstein-Barr virus: 40 years on. Nat Rev Cancer. 4:757–768. 2004. View Article : Google Scholar : PubMed/NCBI
2	Posnett DN: Herpesviruses and autoimmunity. Curr Opin Investig Drugs. 9:505–514. 2008.PubMed/NCBI
3	Salvetti M, Giovannoni G and Aloisi F: Epstein-Barr virus and multiple sclerosis. Curr Opin Neurol. 22:201–206. 2009. View Article : Google Scholar : PubMed/NCBI
4	Babcock GJ, Decker LL, Volk M and Thorley-Lawson DA: EBV persistence in memory B cells in vivo. Immunity. 9:395–404. 1998. View Article : Google Scholar : PubMed/NCBI
5	Rickinson AB, Long HM, Palendira U, Munz C and Hislop AD: Cellular immune controls over Epstein-Barr virus infection: New lessons from the clinic and the laboratory. Trends Immunol. 35:159–169. 2014. View Article : Google Scholar : PubMed/NCBI
6	Kurth J, Spieker T, Wustrow J, Strickler GJ, Hansmann LM, Rajewsky K and Küppers R: EBV-infected B cells in infectious mononucleosis: Viral strategies for spreading in the B cell compartment and establishing latency. Immunity. 13:485–495. 2000. View Article : Google Scholar : PubMed/NCBI
7	Hall LD, Eminger LA, Hesterman KS and Heymann WR: Epstein-Barr virus: Dermatologic associations and implications: Part I. Mucocutaneous manifestations of Epstein-Barr virus and nonmalignant disorders. J Am Acad Dermatol. 72:1–19. 2015. View Article : Google Scholar : PubMed/NCBI
8	Di Lernia V and Mansouri Y: Epstein-Barr virus and skin manifestations in childhood. Int J Dermatol. 52:1177–1184. 2013. View Article : Google Scholar : PubMed/NCBI
9	Berger JS, Eraso LH, Sha D and Mohler ER III: Mean platelet volume and prevalence of peripheral artery disease, the National Health and Nutrition Examination Survey, 1999–2004. Atherosclerosis. 213:586–591. 2010. View Article : Google Scholar : PubMed/NCBI
10	Abalı G, Akpınar O and Söylemez N: Correlation of the coronary severity scores and mean platelet volume in diabetes mellitus. Adv Ther. 31:140–148. 2014. View Article : Google Scholar : PubMed/NCBI
11	Sansanayudh N, Numthavaj P, Muntham D, Yamwong S, McEvoy M, Attia J, Sritara P and Thakkinstian A: Prognostic effect of mean platelet volume in patients with coronary artery disease. A systematic review and meta-analysis. Thromb Haemost. 114:1299–1309. 2015. View Article : Google Scholar : PubMed/NCBI
12	Yang SI, Geong JH and Kim JY: Clinical characteristics of primary Epstein Barr virus hepatitis with elevation of alkaline phosphatase and γ-glutamyltransferase in children. Yonsei Med J. 55:107–112. 2014. View Article : Google Scholar : PubMed/NCBI
13	Golwala ZM, Shah H, Gupta N, Sreenivas V and Puliyel JM: Mean platelet volume (MPV), platelet distribution width (PDW), platelet count and plateletcrit (PCT) as predictors of in-hospital paediatric mortality: A case-control Study. Afr Health Sci. 16:356–362. 2016. View Article : Google Scholar : PubMed/NCBI
14	Loonen AJ, de Jager CP, Tosserams J, Kusters R, Hilbink M, Wever PC and van den Brule AJ: Biomarkers and molecular analysis to improve bloodstream infection diagnostics in an emergency care unit. PLoS One. 9:e873152014. View Article : Google Scholar : PubMed/NCBI
15	Naess A, Nilssen SS, Mo R, Eide GE and Sjursen H: Role of neutrophil to lymphocyte and monocyte to lymphocyte ratios in the diagnosis of bacterial infection in patients with fever. Infection. 45:299–307. 2017. View Article : Google Scholar : PubMed/NCBI
16	Zheng CF, Liu WY, Zeng FF, Zheng MH, Shi HY, Zhou Y and Pan JY: Prognostic value of platelet-to-lymphocyte ratios among critically ill patients with acute kidney injury. Critical Care. 21:2382017. View Article : Google Scholar : PubMed/NCBI
17	Chan CW, Chiang AK, Chan KH and Lau AS: Epstein- Barr-virus-associated infectious mononucleosis in Chinese children. Pediatr Infect Dis J. 22:974–978. 2003. View Article : Google Scholar : PubMed/NCBI
18	Taai MH, Hsu CY, Yen MH, Yan DC, Chiu CH, Huang YC, Lin SJ and Lin TY: Epstein-Barr-virus-associated infectious mononucleosis and risk factor analysis for complications hospitalized children. J Microbio Immunol Infect. 38:255–261. 2005.
19	Hislop AD, Taylor GS, Sauce D and Rickinson AB: Cellular responses to viral infection in humans: Lessons from Epstein-Barr virus. Annu Rev Immunol. 25:587–617. 2007. View Article : Google Scholar : PubMed/NCBI
20	Luzuriaga K and Sullivan JL: Infectious mononucleosis. N Engl J Med. 362:1993–2000. 2010. View Article : Google Scholar : PubMed/NCBI
21	Liu X, Shen Y, Wang H, Ge Q, Fei A and Pan S: Prognostic significance of neutrophil-to-lymphocyte ratio in patients with sepsis: A prospective observational study. Mediators Inflamm 2016:. 191254:2016.
22	Oh GH, Chung SP, Park YS, Hong JH, Lee HS, Chung HS, You JS, Park JW and Park I: Mean platelet volume to platelet count ratio as a promising predictor of early mortality in severe sepsis. Shock. 47:323–330. 2017. View Article : Google Scholar : PubMed/NCBI
23	Ulutas KT, Dokuyucu R, Sefil F, Yengil E, Sumbul AT, Rizaoglu H, Ustun I, Yula E, Sabuncu T and Gokce C: Evaluation of mean platelet volume in patients with type 2 diabetes mellitus and blood glucose regulation: A marker for atherosclerosis? Int J Clin Exp Med. 7:955–961. 2014.PubMed/NCBI
24	Kodiatte TA, Manikyam UK, Rao SB, Jagadish TM, Reddy M, Lingaiah HK and Lakshmaiah V: Mean platelet volume in type 2 diabetes mellitus. J Lab Physicians. 4:5–9. 2012. View Article : Google Scholar : PubMed/NCBI
25	O Malley T, Langhome P, Elton RA and Stewart C: Platelet size in stroke patients. Stroke. 26:995–999. 1995. View Article : Google Scholar : PubMed/NCBI
26	Gao Ju and Luo Chunhua: The pathogenesis and diagnosis of autoimmune thrombocytopenic purpura progress in governance. Chin J Prac Pediatrics. 18:772003.
27	Harries JT and Ferguson AW: Fatal infectious mononucleosis with liver failure in two sisters. Arch Dis Child. 43:480–485. 1968. View Article : Google Scholar : PubMed/NCBI
28	McMahon JM, Elliott CW and Green RC: Infectious mononucleosis complicated by hepatic coma. Am J Gastroenterol. 51:200–207. 1969.PubMed/NCBI
29	Rosalki SB and Rau D: Serum-glutamyl transpeptidase activity in alcoholism. Clin Chim Acta. 39:41–47. 1972. View Article : Google Scholar : PubMed/NCBI
30	Banderas DZ, Escobedo J, Gonzalez E, Liceaga MG, Ramírez JC and Castro MG: γ-Glutamyl transferase: A marker of nonalcoholic fatty liver disease in patients with the metabolic syndrome. Eur J Gastroenterol Hepatol. 24:805–810. 2012. View Article : Google Scholar : PubMed/NCBI
31	Wadsworth RC and Keil PG: Biopsy of the liver in infectious mononucleosis. Am J Pathol. 28:1003–1025. 1952.PubMed/NCBI