Epstein-Barr virus serology and PCR: conflicting results in an immunocompetent host. A case report and review of literature.

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Acta Clinica Belgica Pub Date : 2014-08-01 Epub Date: 2014-06-10 DOI:10.1179/2295333714Y.0000000037
L Cattoir, V Van Hende, P De Paepe, E Padalko
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引用次数: 3

Abstract

We present the case of a 27-year-old immunocompetent man who progressively developed a generalized lymphadenopathy and B symptoms. Results of Epstein-Barr virus (EBV) serology were suggestive for a past infection, but the EBV viral load in whole blood was high. Also, core needle biopsy of the largest lymph node showed an image which could fit an EBV-driven reactive lymphoproliferation. Despite the absence of an immune disorder, all medical evidence points to an EBV-driven lymphoproliferative proces. In immunocompetent patients, it seems extremely uncommon to detect a high EBV viral load in the absence of serological evidence of an acute EBV infection or reactivation. We reviewed literature on this topic and on the selection of the appropriate sample type for EBV PCR, as this is known to be a critical point. Serological testing for the diagnosis of EBV infection is the gold standard in immunocompetent patients. Measuring EBV viral load is only recommended when dealing with immunocompromised patients. Although extremely rare, this case report shows that there is a place for EBV PCR in certain situations in immunocompetent patients. Besides, there is still no consensus regarding the specimen of choice for the determination of the EBV viral load. The preferred specimen type seems to depend on the patient's underlying condition.

爱泼斯坦-巴尔病毒血清学和PCR:在免疫功能强的宿主中相互矛盾的结果。病例报告及文献复习。
我们提出的情况下,一个27岁的免疫能力的人谁逐渐发展为全身性淋巴结病和B症状。eb病毒(EBV)血清学结果提示既往感染,但全血EBV病毒载量高。此外,最大淋巴结的核心穿刺活检显示的图像符合ebv驱动的反应性淋巴增生。尽管没有免疫紊乱,但所有医学证据都指向ebv驱动的淋巴细胞增殖过程。在免疫功能正常的患者中,在没有急性EBV感染或再激活的血清学证据的情况下,检测到高EBV病毒载量似乎极为罕见。我们回顾了关于这一主题和EBV PCR合适样本类型选择的文献,因为这是一个已知的临界点。诊断EBV感染的血清学检测是免疫功能正常患者的金标准。只有在处理免疫功能低下的患者时才推荐测量EBV病毒载量。虽然极为罕见,但本病例报告表明,在免疫功能正常的患者中,EBV PCR在某些情况下有一席之地。此外,对于选择何种标本检测EBV病毒载量仍未达成共识。首选的标本类型似乎取决于患者的基础条件。
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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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