Kolesnik Y. Improvement of prognosis of the course and outcomes of infectious mononucleosis in children on the basis of clinical and immunological manifestations of the disease and structural organization of blood lymphocytes of patients

The thesis is devoted to the improvement of prognosis of the course and outcomes of infectious mononucleosis in children by determining the criteria for early diagnosis on the basis of clinical and immunological manifestations of the disease and the structural organization of blood lymphocytes of patients. It is established that the clinical picture of IM and the results of conventional laboratory and instrumental examination of children with IM in the early stages of the disease reflect a possible variant of its further course. It was found that the most informative clinical signs in the onset of the disease are: the severity of hepatolienal (I = 1.40) and lymphoproliferative (I = 0.73) syndromes, among the laboratory-instrumental signs ─ change in the formula of peripheral blood (content of segmental lymphocytes ─ = 1.73, the number of platelets ─ I = 0.87, the content of monocytes ─ I = 0.82). Data on the pathogenetic mechanisms of formation of these variants of infectious mononucleosis have been supplemented. It is proved that the acute course of the disease is formed against the background of normocompensatory reaction of the child's body, with a prolonged course deficit of compensation is determined. For the first time the pathogenetic role of disturbance of structural organization of blood lymphocytes in formation of a course of MI is proved. It was found that these disorders in the form of increased permeability of their cytoplasmic membrane and reduced viscoelastic properties of their intracellular environment are more pronounced with a prolonged course of the disease, which is probably a factor in the prolongation of the disease. For the first time it was found that in the period of convalescence in patients with acute infectious mononucleosis normalization of biophysical organization of lymphocyte structure is observed, and in patients with prolonged course of the disease there are increased indicators of permeability of a membrane of lymphocytes and the lowered levels of viscoelastic properties of their intracellular environment remain. This, in turn, leads to the exhaustion of the functional capabilities of blood lymphocytes, and hence - there are prerequisites for the development of OGD. For the first time it was determined that the indicators of cellular and humoral parts of the immune system affect the course of IM.