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Title: Epstein-Barr virus serology and PCR: conflicting results in an immunocompetent host. A case report and review of literature
Authors: Cattoir, L.
Van Hende, V.
De Paepe, P.
PADALKO, Elizaveta 
Issue Date: 2014
Source: ACTA CLINICA BELGICA, 69 (4), p. 262-266
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.
Notes: [Cattoir, L.; Padalko, E.] Ghent Univ Hosp, Dept Clin Chem Microbiol & Immunol, B-9000 Ghent, Belgium. [Van Hende, V.] Ghent Univ Hosp, Dept Hematol, B-9000 Ghent, Belgium. [De Paepe, P.] AZ Sint Jan Bruges Ostend AV, Dept Pathol, Brugge, Belgium. [Padalko, E.] Hasselt Univ, Sch Life Sci, Diepenbeek, Belgium.
Keywords: Epstein-Barr virus; Serology; PCR; Immunocompetent; Specimen type;Epstein–Barr virus; serology; PCR; immunocompetent; specimen type
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ISSN: 1784-3286
e-ISSN: 2295-3337
DOI: 10.1179/2295333714Y.0000000037
ISI #: 000339727900005
Category: A1
Type: Journal Contribution
Validations: ecoom 2015
Appears in Collections:Research publications

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