Use of the lymphocyte count as a diagnostic screen in adults with suspected epstein-barr virus infectious mononucleosis
Objectives/Hypothesis To evaluate the predictive diagnostic accuracy of the lymphocyte count in Epstein–Barr virus–related infectious mononucleosis (IM). Study Design Retrospective case note and blood results review within a university‐affiliated teaching hospital. Methods A retrospective review of...
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| Veröffentlicht in: | The Laryngoscope 2013-10, Vol.123 (10), p.2401-2404 |
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| container_title | The Laryngoscope |
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| creator | Biggs, Timothy C. Hayes, Stephen M. Bird, Jonathan H. Harries, Philip G. Salib, Rami J. |
| description | Objectives/Hypothesis
To evaluate the predictive diagnostic accuracy of the lymphocyte count in Epstein–Barr virus–related infectious mononucleosis (IM).
Study Design
Retrospective case note and blood results review within a university‐affiliated teaching hospital.
Methods
A retrospective review of 726 patients undergoing full blood count and Monospot testing was undertaken. Monospot testing outcomes were compared with the lymphocyte count, examining for significant statistical correlations.
Results
With a lymphocyte count of ≤4 × 109/L, 99% of patients had an associated negative Monospot result (sensitivity of 84% and specificity of 94%). A group subanalysis of the population older than 18 years with a lymphocyte count ≤4 × 109/L revealed that 100% were Monospot negative (sensitivity of 100% and specificity of 97%). A lymphocyte count of ≤4 × 109/L correlated significantly with a negative Monospot result.
Conclusions
A lymphocyte count of ≤4 × 109/L appears to be a highly reliable predictor of a negative Monospot result, particularly in the population aged >18 years. Pediatric patients, and adults with strongly suggestive symptoms and signs of IM, should still undergo Monospot testing. However, in adults with more subtle symptoms and signs, representing the vast majority, Monospot testing should be restricted to those with a lymphocyte count >4 × 109/L.
Level of Evidence
NA Laryngoscope, 123:2401–2404, 2013 |
| doi_str_mv | 10.1002/lary.24030 |
| format | Article |
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To evaluate the predictive diagnostic accuracy of the lymphocyte count in Epstein–Barr virus–related infectious mononucleosis (IM).
Study Design
Retrospective case note and blood results review within a university‐affiliated teaching hospital.
Methods
A retrospective review of 726 patients undergoing full blood count and Monospot testing was undertaken. Monospot testing outcomes were compared with the lymphocyte count, examining for significant statistical correlations.
Results
With a lymphocyte count of ≤4 × 109/L, 99% of patients had an associated negative Monospot result (sensitivity of 84% and specificity of 94%). A group subanalysis of the population older than 18 years with a lymphocyte count ≤4 × 109/L revealed that 100% were Monospot negative (sensitivity of 100% and specificity of 97%). A lymphocyte count of ≤4 × 109/L correlated significantly with a negative Monospot result.
Conclusions
A lymphocyte count of ≤4 × 109/L appears to be a highly reliable predictor of a negative Monospot result, particularly in the population aged >18 years. Pediatric patients, and adults with strongly suggestive symptoms and signs of IM, should still undergo Monospot testing. However, in adults with more subtle symptoms and signs, representing the vast majority, Monospot testing should be restricted to those with a lymphocyte count >4 × 109/L.
Level of Evidence
NA Laryngoscope, 123:2401–2404, 2013</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.24030</identifier><identifier>PMID: 23918629</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Child ; diagnosis ; Epstein-Barr virus ; Epstein-Barr Virus Infections - diagnosis ; Female ; glandular fever ; HIV ; Human immunodeficiency virus ; Humans ; Infectious mononucleosis ; Infectious Mononucleosis - diagnosis ; Infectious Mononucleosis - virology ; lymphocyte ; Lymphocyte Count ; Lymphocytes ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Teaching hospitals ; tonsillitis ; Young Adult</subject><ispartof>The Laryngoscope, 2013-10, Vol.123 (10), p.2401-2404</ispartof><rights>Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3950-daf71ee914f8abea5a6d8bbe1d33f7630f888682022049d725ae7591bcf699e33</citedby><cites>FETCH-LOGICAL-c3950-daf71ee914f8abea5a6d8bbe1d33f7630f888682022049d725ae7591bcf699e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.24030$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.24030$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23918629$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Biggs, Timothy C.</creatorcontrib><creatorcontrib>Hayes, Stephen M.</creatorcontrib><creatorcontrib>Bird, Jonathan H.</creatorcontrib><creatorcontrib>Harries, Philip G.</creatorcontrib><creatorcontrib>Salib, Rami J.</creatorcontrib><title>Use of the lymphocyte count as a diagnostic screen in adults with suspected epstein-barr virus infectious mononucleosis</title><title>The Laryngoscope</title><addtitle>The Laryngoscope</addtitle><description>Objectives/Hypothesis
To evaluate the predictive diagnostic accuracy of the lymphocyte count in Epstein–Barr virus–related infectious mononucleosis (IM).
Study Design
Retrospective case note and blood results review within a university‐affiliated teaching hospital.
Methods
A retrospective review of 726 patients undergoing full blood count and Monospot testing was undertaken. Monospot testing outcomes were compared with the lymphocyte count, examining for significant statistical correlations.
Results
With a lymphocyte count of ≤4 × 109/L, 99% of patients had an associated negative Monospot result (sensitivity of 84% and specificity of 94%). A group subanalysis of the population older than 18 years with a lymphocyte count ≤4 × 109/L revealed that 100% were Monospot negative (sensitivity of 100% and specificity of 97%). A lymphocyte count of ≤4 × 109/L correlated significantly with a negative Monospot result.
Conclusions
A lymphocyte count of ≤4 × 109/L appears to be a highly reliable predictor of a negative Monospot result, particularly in the population aged >18 years. Pediatric patients, and adults with strongly suggestive symptoms and signs of IM, should still undergo Monospot testing. However, in adults with more subtle symptoms and signs, representing the vast majority, Monospot testing should be restricted to those with a lymphocyte count >4 × 109/L.
Level of Evidence
NA Laryngoscope, 123:2401–2404, 2013</description><subject>Adolescent</subject><subject>Adult</subject><subject>Child</subject><subject>diagnosis</subject><subject>Epstein-Barr virus</subject><subject>Epstein-Barr Virus Infections - diagnosis</subject><subject>Female</subject><subject>glandular fever</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infectious mononucleosis</subject><subject>Infectious Mononucleosis - diagnosis</subject><subject>Infectious Mononucleosis - virology</subject><subject>lymphocyte</subject><subject>Lymphocyte Count</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Teaching hospitals</subject><subject>tonsillitis</subject><subject>Young Adult</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAQhS0Eokvhwg9AlrggpBQ7jhP7WLZQkFZFAirgZDnOmHVJ7GA7LPvvcdm2Bw6cZqT3zdPTPISeUnJCCalfjTruT-qGMHIPrShntGqk5PfRqoisErz-eoQepXRFCO0YJw_RUc0kFW0tV2h3mQAHi_MW8Lif5m0w-wzYhMVnrBPWeHD6uw8pO4OTiQAeO4_1sIw54Z3LW5yWNIPJMGCYUwbnq17HiH-5uKTC2qK5UNYp-OAXM0JILj1GD6weEzy5mcfo8u2bz-t31ebD-fv16aYyTHJSDdp2FEDSxgrdg-a6HUTfAx0Ys13LiBVCtKImdU0aOXQ119BxSXtjWymBsWP04uA7x_BzgZTV5JKBcdQeSihFGyZ4x4gkBX3-D3oVluhLukI1jNNGtLRQLw-UiSGlCFbN0U2lAUWJuq5DXdeh_tZR4Gc3lks_wXCH3v6_APQA7NwI-_9Yqc3px2-3ptXhxpVv_7670fGHajvWcfXl4lx9uiDr5uysVa_ZHw8LpgA</recordid><startdate>201310</startdate><enddate>201310</enddate><creator>Biggs, Timothy C.</creator><creator>Hayes, Stephen M.</creator><creator>Bird, Jonathan H.</creator><creator>Harries, Philip G.</creator><creator>Salib, Rami J.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201310</creationdate><title>Use of the lymphocyte count as a diagnostic screen in adults with suspected epstein-barr virus infectious mononucleosis</title><author>Biggs, Timothy C. ; Hayes, Stephen M. ; Bird, Jonathan H. ; Harries, Philip G. ; Salib, Rami J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3950-daf71ee914f8abea5a6d8bbe1d33f7630f888682022049d725ae7591bcf699e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Child</topic><topic>diagnosis</topic><topic>Epstein-Barr virus</topic><topic>Epstein-Barr Virus Infections - diagnosis</topic><topic>Female</topic><topic>glandular fever</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infectious mononucleosis</topic><topic>Infectious Mononucleosis - diagnosis</topic><topic>Infectious Mononucleosis - virology</topic><topic>lymphocyte</topic><topic>Lymphocyte Count</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Teaching hospitals</topic><topic>tonsillitis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Biggs, Timothy C.</creatorcontrib><creatorcontrib>Hayes, Stephen M.</creatorcontrib><creatorcontrib>Bird, Jonathan H.</creatorcontrib><creatorcontrib>Harries, Philip G.</creatorcontrib><creatorcontrib>Salib, Rami J.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Biggs, Timothy C.</au><au>Hayes, Stephen M.</au><au>Bird, Jonathan H.</au><au>Harries, Philip G.</au><au>Salib, Rami J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of the lymphocyte count as a diagnostic screen in adults with suspected epstein-barr virus infectious mononucleosis</atitle><jtitle>The Laryngoscope</jtitle><addtitle>The Laryngoscope</addtitle><date>2013-10</date><risdate>2013</risdate><volume>123</volume><issue>10</issue><spage>2401</spage><epage>2404</epage><pages>2401-2404</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
To evaluate the predictive diagnostic accuracy of the lymphocyte count in Epstein–Barr virus–related infectious mononucleosis (IM).
Study Design
Retrospective case note and blood results review within a university‐affiliated teaching hospital.
Methods
A retrospective review of 726 patients undergoing full blood count and Monospot testing was undertaken. Monospot testing outcomes were compared with the lymphocyte count, examining for significant statistical correlations.
Results
With a lymphocyte count of ≤4 × 109/L, 99% of patients had an associated negative Monospot result (sensitivity of 84% and specificity of 94%). A group subanalysis of the population older than 18 years with a lymphocyte count ≤4 × 109/L revealed that 100% were Monospot negative (sensitivity of 100% and specificity of 97%). A lymphocyte count of ≤4 × 109/L correlated significantly with a negative Monospot result.
Conclusions
A lymphocyte count of ≤4 × 109/L appears to be a highly reliable predictor of a negative Monospot result, particularly in the population aged >18 years. Pediatric patients, and adults with strongly suggestive symptoms and signs of IM, should still undergo Monospot testing. However, in adults with more subtle symptoms and signs, representing the vast majority, Monospot testing should be restricted to those with a lymphocyte count >4 × 109/L.
Level of Evidence
NA Laryngoscope, 123:2401–2404, 2013</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>23918629</pmid><doi>10.1002/lary.24030</doi><tpages>4</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Adult Child diagnosis Epstein-Barr virus Epstein-Barr Virus Infections - diagnosis Female glandular fever HIV Human immunodeficiency virus Humans Infectious mononucleosis Infectious Mononucleosis - diagnosis Infectious Mononucleosis - virology lymphocyte Lymphocyte Count Lymphocytes Male Middle Aged Retrospective Studies Sensitivity and Specificity Teaching hospitals tonsillitis Young Adult |
| title | Use of the lymphocyte count as a diagnostic screen in adults with suspected epstein-barr virus infectious mononucleosis |
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