Retrospective evaluation of clinical features of EBV infected patients presenting with hematological findings

Objective: Epstein-Barr virus (EBV) is a latent DNA virus that infects B lymphocytes, can cause widespread hematological findings, and can cause various disease manifestations. In our study, it was aimed to examine the data of patients with hematological findings who had primary EBV infection or reactivation. Materials and methods: The files of the patients whose EBV serology was evaluated and followed up with the diagnosis of EBV between January 2010 and December 2021 in the outpatient clinics of Karadeniz Technical University Faculty of Medicine, Department of Pediatrics, Pediatric Hematology-Oncology and/or Pediatric Infection Department were reviewed. Results: Of the 2200 screened patients, 204 were included in the study as EBV primary infection and 117 as EBV reactivation. Concurrent hematological findings were present in 91.1% of patients with EBV primary infection and in 90.6% of patients with reactivation. The most common complaints in primary EBV infection were fever (70.5%), sore throat (70.5%), and palpable lymph node (62.7%). The most common complaints in the reactivation group were; fever (76.9%), sore throat (65.8%) and palpable lymph node (64.1%). The rate of lymphocytosis in blood tests and peripheral smears in the primary infection group was significantly higher than in the reactivation group (p<0.05). The incidence of leukopenia, lymphopenia and pancytopenia was significantly higher in the reactivation group (p<0.05). The AST and ALT elevations of the primary infection group were significantly higher than the reactivation group (p<0.05). It was observed that malignancy developed in 5.1% of the patients with EBV reactivation. Conclusion: EBV is a virus that can cause various hematological findings, especially lymphomonocytosis. It has the feature of being latent in the body and being reactivated in cases such as immunosuppression. In EBV primary infection or reactivation with hematological findings, transaminase and bilirubin follow-up, as well as peripheral smear evaluation are important. Patients who have undergone EBV should be followed closely in terms of diseases that may develop due to EBV, especially malignancies.