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Risk Factors for Transaminase Elevation in Children with Epstein-Barr Virus Infectious Mononucleosis


 Objective: To study the risk factors of Epstein-Barr virus (EBV) infectious mononucleosis (EBV-IM) in children with elevated transaminase. Methods: A retrospective analysis of the clinical data of 533 children with EBV-IM who were hospitalized and diagnosed in the Affiliated Hospital of Southwest Medical University from January 1, 2018, to May 31, 2021. The alanine aminotransferase (ALT)> 40U/L or aspartate aminotransferase (AST)>40U/L was defined as elevated transaminase and divided into normal group and abnormal group based on that. Monofactor analysis and logistic regression analysis were used to explore the risk factors of EBV-IM with the elevation of transaminase, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive ability of each indicator. Results: Of the 533 cases, 428 cases (80.3%) were in the transaminase elevation group，there were 277 cases(52.0%) of ALT elevation and 414 cases(77.7%) of AST elevation. The multifactor Logistic regression showed that the fever, age, γ-glutamyl transferase(GGT), atypical lymphocyte(ALYM), and albumin(ALB) were associated with elevated ALT (OR=0.351, 1.140, 1.053, 1.032, 0.912, All P<0.05) and age, GGT, ALYM, ALB predict the area under the ROC curve(AUC) of EBV-IM with ALT elevation were 0.665, 0.890, 0.579, 0.669,and GGT, mean platelet volume to platelet count(MPV/PLT%) were correlated with increased AST(OR=1.029, 1.220, all P<0.05 ) the AUC predicted GGT and MPV/PLT(%) for EBV-IM and AST increase were 0.715 and 0.623.Conclusion: With EBV-IM in children, Fever, age, GGT, ALYM, and ALB are risk factors for ALT elevation, and GGT, MPV/PLT(%) are risk factors for AST elevation.