{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T07:14:37Z","timestamp":1780384477602,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,9,7]],"date-time":"2012-09-07T00:00:00Z","timestamp":1346976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hemophagocytic lymphohistiocytosis (<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>) is a potentially fatal condition in children with<jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>pstein\u2013<jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>arr virus (<jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content>)\u2010associated infectious mononucleosis (<jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content>). This study aimed to identify commonly available clinical and laboratory predictors that might help clinicians decide to perform the bone marrow and immunological tests for<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>in paediatric<jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content>\u2010associated<jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective case\u2013control study of patients aged &lt;18\u00a0yr diagnosed with<jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content>\u2010associated<jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content>and<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>from 1991 to 2010 in a tertiary medical centre was conducted. A diagnosis of<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>was defined as fulfilling the criteria of the guidelines of the<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>\u20102004 protocol of the<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>istiocyte<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>ociety and consisted of at least evidence of hemophagocytosis in a bone marrow biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 177<jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content>and 27<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>patients were enrolled. The mean age was 5.3\u00a0yr with a female\u2010to\u2010male ratio of 1.06. The most common characteristics (&gt;70% of patients) were fever, lymphadenopathy and hepatomegaly. In addition to the diagnostic criteria of<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>including fever, splenomegaly, cytopenia, hyperferritinaemia, hypertriglyceridemia and\/or hypofibrinogenaemia, children with<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>had a significantly higher rate of prolonged fever &gt;10\u00a0d, hepatomegaly, jaundice, general malaise, elevated aspartate aminotransferase, lactate dehydrogenase,<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u2010reactive protein and hypoalbuminaemia compared to those with<jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content>(all<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). Multiple logistic regression confirmed that hypoalbuminaemia (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a023.1,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) was an independent predictor of paediatric<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>, with a high sensitivity (96%) and a good negative likelihood ratio (0.06) in patients with<jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content>\u2010associated<jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hypoalbuminaemia is a unique characteristic and potentially a valuable predictor for<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>in paediatric<jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content>\u2010associated<jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.12006","type":"journal-article","created":{"date-parts":[[2012,8,16]],"date-time":"2012-08-16T10:35:10Z","timestamp":1345113310000},"page":"417-422","source":"Crossref","is-referenced-by-count":16,"title":["Hypoalbuminaemia is an independent predictor for hemophagocytic lymphohistiocytosis in childhood<scp>E<\/scp>pstein\u2013<scp>B<\/scp>arr virus\u2010associated infectious mononucleosis"],"prefix":"10.1111","volume":"89","author":[{"given":"Shu\u2010Ching","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Paediatrics Kuo General Hospital Tainan Taiwan"},{"name":"Department of Paediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiann\u2010Shiuh","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao\u2010Neng","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Paediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao\u2010Jong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Paediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan 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