Aim: The aim of this clinical prospective study is to evaluate the relationship between Epstein-Barr virus (EBV) and asymmetric and symmetric tonsillar hypertrophy in children between 3-14 years old.
Material and Method: Tonsil size of forty two children were evaluated a orophayrngeal inspection preoperatively.Tonsils were grouped according to Brodsky L scala classification (Grade 1-4).Childrens are separated into two groups including the ones that have grade 1-2 and grade 3-4 tonsil size, +1 difference between two tonsils was accepted as tonsillar asymmetry. Viral capsid antigen IgG (VCA IgG), viral capsid antigen IgM (VCA IgM), early antigen and EBV nuclear antigen (EBNA) levels were measured in serum preoperatively. EBV latent membrane protein-1 and EBNA-2 levels were determined with immunohistochemical studies after paraffin sectioning. Chi-square and Fisher's exact tests were used to compare groups. The study was approved by the ethics commite (KA0992).
Results: The 20 of the cases were boy and 22 were girl. The mean age was 7.12 [+ or -] 2.07. There were no significant difference between groups, among age and gender distribution. Thirty-two children (76.2%) were sero-positive for VCA IgG. Among 62.5% of them, EBNA IgG was also positive. VCA IgG was significanlty higher in children with tonsillar hypertrophy grade 3-4 and EBNA was significantly higher in children with tonsillar hypertrophy grade 1 -2. All tonsil spacements are evaluated as chronic tonsillit that shows lymphoid hyperplasia. 35.7% of EBV is found by immunohistochemical staining. This ratio is determined as 28.6% for latent membran protein-1 and 19% for EBNA. The relationship between EBV and degree of tonsillar hypertrophy was found to be statistically insignificant (p>0.05). Asymetric tonsillar hypertrophy were seen among 16.7% of the children. The relationship between EBV and asymetric tonsillar hypertrophy was also found to be statistically insignificant (p>0.05).
Conclusions: We found statistical correlation between the grade of tonsillar hypertrophy and viral load in serum. This study points out the reservoir of EBV in tonsil tissue. (Turk Arch Ped 2013; 48:30-4)
Key words: Asymmetric tonsil, Epstein Barr virus, recurrent tonsillitis, tonsillar hypertrophy
Amac: Bu klinik ileriye donuk calisma ile, tonsillektomi gerekcesi bulunan 3-14 yas arasi cocuklarda simetrik ve asimetrik tonsiller hipertrofi ile Epstein Barr virusu (EBV) arasindaki iliskinin arastirilmasi amaclandi.
Gerec ve Yontem: Calismaya alinan 42 olguda tonsil buyuklugu ameliyat oncesinde, orofaringeal goruntusu ile degerlendirildi. Derecelendirme icin, Brodsky L skalasi (evre 1-4) kullanildi. Olgular tonsil buyuklugu evre 1-2 olanlar ve tonsil buyuklugu evre 3-4 olanlar olarak iki gruba ayrildi, tonsiller arasinda 1+ fark asimetrik hipertrofi kabul edildi. Ameliyat oncesi alinan kan orneklerinde viral kapsid antijen IgG (VCA IgG), viral kapsid antijen IgM (VCA IgM), "early antijen" ve EBV nukleer antijen (EBNA) duzeyleri olculdu. Tonsillektomi maddelerinde EBV icin immunohistokimyasal yontem ile EBV virusu latent membran protein-1 ve EBNA-2 duzeyleri belirlendi. Calismada elde edilen verilerin karsilastirilmasinda ki-kare test ve Fisher's exact test kullanildi. Calisma icin etik kurul onayi alindi (KA0992).
Bulgular: Olgularin 20'si erkek, 22'si kiz olup yas ortalamasi 7,12 [+ or -] 2,07 idi. Gruplar arasinda yas ve cinsiyet acisindan anlamli fark yoktu. Otuz iki olguda (%76,2)...
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