of Laboratory, Maternal and Child Health Hospital of Hubei Province,
2 Department of Infectious Disease, The first people's Hospital of Guangshui, China
3 Department of Pediatrics, Maternal and Child Health Hospital of Hubei Province, China
4 Medical department, The first people's Hospital of Guangshui, China.
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Background: Henoch-Schönlein purpura (HSP) is an immune-mediated vasculitis, and the formation of immune complexes may be triggered by exposure to Epstein-Barr virus (EBV) infection.
Methods: We performed a five-year case-control study to evaluate the epidemiology and clinical characteristics of HSP associated with EBV infection.
Results: The incidence of EBV-triggered HSP was 4.2%, while EBV infection in children with HSP was 0.9%; The EBV-triggered HSP cases had a significantly higher frequency of abdominal pain than the Mycoplasma Pneumoniae (MP)-triggered HSP group (χ2 = 8.024, p = 0.005); Significant differences were observed in the duration of abdominal pain (Z = -1.935, p = 0.027) between the two groups; C3 (t = 9.709, p < 0.001), IgA (t = 20.39, p < 0.001) and IgG (t = 6.407, p < 0.001) were significantly increased in the EBV infection group than those in the healthy control group. Notably, significantly higher proportion of CD19 (t = 6.773, p < 0.001) and lower proportion of CD56 (t = 11.13, p < 0.001) was found in EBV infection group compared with healthy control group. The IgA level was higher than that of the non-infectious group (t = 2.162, p = 0.032), but their CD4/CD8 ratio (t = 10.070, p < 0.001) and CD56 proportion (t = 2.096, p = 0.037) were significantly lower.
Conclusions: Both cellular and
humoral immunity were
involved in the pathogenesis of EBV-triggered HSP, leading to increased
production of inflammatory mediators and immunoglobulins. Those events
cause or promote the development of systemic vessel vasculitis.
Monthly or seasonal distribution of cases in HSP and EBV infection. B. Age distribution
in HSP and EBV infection. C.
Gender distribution in HSP and EBV infection.
|Table 1. The frequency of EBV infection in Chinese pediatric population.|
|Table 2. Clinical manifestations and duration of main symptoms between EBV infection cases and non- infected cases.|
|Table 3. Clinical manifestations and duration of main symptoms between EBV-triggered HSP and MP-triggered HSP cases.|
|Figure 2. Laboratory results of the EBV-triggered HSP cases, non-infectious cases (n=122), MP-triggered HSP cases (n=57) and healthy control (n=122), *, p＜0.05.|