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Analysis of two laboratory tests for determination of EBV‐IM in children

This study aimed to explore the application value of two laboratory tests in the diagnosis of Epstein‐Barr virus‐associated infectious mononucleosis (EBV‐IM) in children. From January 2018 to December 2020, 166 patients with EBV‐IM were included in this study. Two methods were used in the analysis. The results of both tests were compared and analyzed. The age of onset of EBV‐IM is mainly distributed in the range of 0–6 years, and no difference by gender is observed. The sensitivity and specificity of EBV testing by PCR were 49.4% and 89.8%, respectively, and the area under the receiver operating characteristic curve (AUC) was 0.714 (0.662–0.762). When using the immunofluorescence method to detect EBV antibodies, the two indices with the highest diagnostic efficacy were low‐affinity EBV‐CA IgG and EBV‐CA IgM, and their AUC values were 0.798 (0.751–0.840) and 0.663 (0.609–0.713), respectively. When combining the two indices for testing, the AUC values of EBV‐CA IgM + low‐affinity EBV‐CA IgG, EBV‐DNA+EBV‐CA IgM, and EBV‐DNA+low‐affinity EBV‐CA IgG were 0.904 (0.867–0.933), 0.768 (0.719–0.812), and 0.963 (0.937–0.981), respectively. The diagnostic efficacy of the combined EBV‐DNA+EBV‐CA IgM + low‐affinity EBV‐CA IgG test was optimal compared with that of a single index or the combination of two indices, with an AUC of 0.999 (0.986–1.000; p < 0.05), sensitivity of 100%, and specificity of 89.8%. The combined immunofluorescence and real‐time PCR methods have high sensitivity and specificity and good application value in the clinical diagnosis of EBV‐IM.