Annenkova I. Clinical pathogenetic characteristics of liver injury in children with infectious mononucleosis

The immune responsiveness of the patient has been found to be the main pathogenetic factor contributing to the formation of the liver's structural-functional state in children with Epstein-Barr virus infectious mononucleosis. In patients free of hepatitis symptoms, the immunity changes are characterized by a balance between the levels of pro-inflammatory and anti-inflammatory cytokines and by the activation of T-lymphocytes. In patients with infectious mononucleosis and hepatitis symptoms, a sharp increase of pro-inflammatory cytokine levels accompanied by the exhausted potential of cytotoxic T-lymphocytes and anti-inflammatory cytokines has been observed. In all the patients with infectious mononucleosis, the changes of the liver's structural-functional state are accompanied by malfunction of portal hemodynamics manifested as reduced blood flow through the liver artery and the portal vein. In patients without hepatitis, compensated changes of hemodynamics are observed, whereas in patients with hepatitis symptoms, the changes are de-compensated. Key words: children, infectious mononucleosis, liver, cytokines, cell immunity, portal hemodynamic.