Cytokine profiles as novel diagnostic markers of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in children

Purpose: The aim of this study was to identify specific laboratory indices to distinguish Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children. Materials and methods: In this prospective study, Th1/Th2 cytokines, including IL-2, IL-4, IL-6, IL-10, TNF-alpha, and IFN-gamma, were analyzed in patients with EBV-HLH or sepsis at the onset of disease by flow cytometry. Results: IL-10, IFN-gamma, IL-10/IL-6, and IFN-gamma/IL-6 were higher and IL-6 was lower in EBV-HLH patients compared to sepsis patient levels. When using the criteria of IL-10 >20.9 pg/mL, IFN-gamma >17.9 pg/mL, IL-10/IL-6 >0.5 and IFN-gamma/IL-6 >0.7, the sensitivity was 89.8%, 93.2%, 93.2%, and 91.5%, while the specificity was 89.8%, 100%, 94.9%, and 100%, respectively. After treatment of EBV-HLH patients, IL-6, IL-10, TNF-alpha, and IFN-gamma. were significantly reduced (IL-6: P < .001; IL-10: P < .001; TNF-alpha: P = .011; IFN-gamma: P < .001). Conclusions: This study showed that IFN-gamma, IL-10/IL-6, and IFN-gamma/IL-6 are novel specific indicators for differential diagnosis of EBV-HLH. Additionally, IL-6, IL-10, TNF-alpha, and IFN-gamma. are useful indices for monitoring the effects of treatment on EBV-HLH. (C) 2017 Elsevier Inc. All rights reserved.