Utilidad de la serie blanca en el diagnóstico diferencial de la mononucleosis infecciosa

Abstract

Introduction: the infectious mononucleosis (IM) is a common disease in childhood. Our objective was to compare the white series of children with suspected IM, based on serology positive/negative for Epstein-Barr Virus (EBV), Cytomegalovirus (CMV) and Paul-Bunnell. Material and methods: descriptive study. Children taken to hospital in 2010-2011, diagnosed with mononucleosis syndrome and positive serology for EBV or CMV were included. An equal number of children who were seronegative were used as control group. Epidemiology, clinical and serological variables were compared. Results: there were 50 children with a positive serology and 50 with negative result (mean age 5.81 years): EBV serology in 44 children, CMV in 2 and both (EBV and CMV) in 4 children. From the 48 children with positive serology for EBV, 26 were Paul-Bunnell negative and 22 positive (these were the 22 total Paul-Bunnell positives). The average number of lymphocytes, monocytes and basophils was higher and neutrophils were lower in children with positive serology for EBV. Children CMV negatives had elevated neutrophils. No age group was associated with increased likelihood of EBV and Paul-Bunnell positive. Conclusions: there is a predominance of lymphocytes, monocytes and basophils in children with EBV IM. The increase in neutrophils is the only analytical variation in children with CMV IM. These analytical values can guide the diagnosis of IM. All children with positive Paul-Bunnell were positive for EBV without relation to age.