Red Cell Distribution Width is a Predictor of Patients with Liver Cell Damage by EBV Infectious Mononucleosis in Children in Southeast China

Background: Epstein-Barr virus infection is common in children. The aim of this study was to find new laboratory indices of infectious mononucleosis in children. Methods: In this prospective study, a total of 141 children with infectious mononucleosis and 146 children without signs of infectious mononucleosis were enrolled. The number of white blood cell count (WBC) and red blood cell count (RBC), levels of hemoglobin (HB), mean blood cell volume (MCV), red blood cell distribution width (RDW), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), uric acid (UA), and creatinine (CREA) in the peripheral blood were evaluated. Results: WBC, RDW, ALT, AST, GGT, and UA in patients were significantly higher compared to controls (p < 0.01, for all), while RBC and HB were significantly lower in patients (p < 0.01, for each). In the stepwise regression analysis, we found that RDW had the highest ratio compared to other parameters, and its 95% confidence interval was 1.362 - 7.929 (p < 0.01). RDW was positively correlated with ALT, AST, and GGT elevations (p < 0.01). While RDW was negatively correlated with HB (p = 0.01). When using the criteria of RDW (%) = 12.55, the sensitivity was 80.9%, and the specificity was 78.8% in IM patients. Conclusions: RDW may be used as a further indicator supporting early IM diagnosis and indirectly predicting the degree of liver cell damage in EBV infectious mononucleosis.