Retrospective cohort identifies TIBC and rPLR cutoffs for EBV-IM-related hepatic injury in children.
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Key Takeaway
Consider TIBC and rPLR cutoffs as potential diagnostic markers for EBV-IM-related hepatic injury in children, noting the observational nature and modest AUC values.
This was a retrospective cohort study from the First Hospital of Jilin University involving 52 pairs of children with EBV-associated infectious mononucleosis (EBV-IM), matched via propensity scores. The study compared children with hepatic injury to a non-hepatic injury group to identify diagnostic markers.
The main results identified a whole blood EBV DNA load >1 × 10^5 copies/mL as a risk factor for hepatic injury and the platelet-to-lymphocyte ratio (PLR) as a protective factor. Diagnostic cutoffs were reported: a total iron-binding capacity (TIBC) cutoff of 53.250 μmol/L with an AUC of 0.652, and a reciprocal platelet-to-lymphocyte ratio (rPLR) cutoff of 0.052 with an AUC of 0.713.
For diagnostic performance, TIBC had a sensitivity of 69.2% and a specificity of 62.7%. The rPLR had a sensitivity of 53.8% and a specificity of 88.2%. No absolute numbers for patient outcomes or effect sizes beyond the AUC were reported.
Safety and tolerability data were not reported. Key limitations include the retrospective design, lack of reported follow-up duration, and absence of p-values or confidence intervals for the main findings. The practice relevance was not reported, and the evidence is observational, so causal conclusions are not supported.
View Original Abstract ↓
ObjectiveTo analyze clinical features of hepatic injury in children with EBV-associated infectious mononucleosis (EBV-IM) and identify its risk factors.MethodsA retrospective analysis of the clinical data of children with EBV-IM admitted to the First Hospital of Jilin University from March 2023 to March 2025 was conducted. Confounding factors were balanced by propensity score matching (PSM). The children were divided into a hepatic injury group and a non-hepatic injury group. The risk factors were examined using binary logistic regression. Furthermore, the diagnostic performance of these risk factors was assessed and presented using receiver operating characteristic (ROC) curves.ResultsAfter PSM, 52 pairs of patients were matched. Statistically significant differences in white blood cell count, the proportion of neutrophils, the proportion and absolute value of lymphocytes, the platelet–to-lymphocyte ratio (PLR), hepatosplenomegaly, whole blood EBV DNA load >1 × 105 copies/mL, and total iron-binding capacity(TIBC) were detected(all P 1 × 105 copies/mL were risk factors, whereas the PLR was a protective factor. ROC curve analysis showed that the cutoff values of TIBC and reciprocal platelet-to-lymphocyte ratio (rPLR) for the diagnosis of EBV-IM-related hepatic injury were 53.250 μmol/L and 0.052, with areas under the curve of 0.652 and 0.713, sensitivities of 69.2% and 53.8%, and specificities of 62.7% and 88.2%, and these two indicators could be used as diagnostic markers for hepatic injury in children with EBV-IM.ConclusionEBV-IM-related hepatic injury in children correlates with iron metabolism. TIBC and whole blood EBV DNA load (>1 × 105 copies/mL) are independent risk factors, whereas the PLR is a protective factor.
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