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

(2014) ACTA CLINICA BELGICA. 69(4). p.262-266
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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.
Keywords
Serology, Epstein-Barr virus, PCR, Immunocompetent, Specimen type, STEM-CELL TRANSPLANTATION, POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER, POLYMERASE-CHAIN-REACTION, BLOOD MONONUCLEAR-CELLS, VIRAL LOAD ASSAYS, REAL-TIME PCR, WHOLE-BLOOD, PERIPHERAL-BLOOD, DNA LOAD, PREEMPTIVE DIAGNOSIS

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Citation

Please use this url to cite or link to this publication:

MLA
Cattoir, Lien, VANESSA VAN HENDE, P De Paepe, et al. “Epstein-Barr Virus Serology and PCR: Conflicting Results in an Immunocompetent Host: a Case Report and Review of Literature.” ACTA CLINICA BELGICA 69.4 (2014): 262–266. Print.
APA
Cattoir, Lien, VAN HENDE, V., De Paepe, P., & Padalko, E. (2014). Epstein-Barr virus serology and PCR: conflicting results in an immunocompetent host: a case report and review of literature. ACTA CLINICA BELGICA, 69(4), 262–266.
Chicago author-date
Cattoir, Lien, VANESSA VAN HENDE, P De Paepe, and Elizaveta Padalko. 2014. “Epstein-Barr Virus Serology and PCR: Conflicting Results in an Immunocompetent Host: a Case Report and Review of Literature.” Acta Clinica Belgica 69 (4): 262–266.
Chicago author-date (all authors)
Cattoir, Lien, VANESSA VAN HENDE, P De Paepe, and Elizaveta Padalko. 2014. “Epstein-Barr Virus Serology and PCR: Conflicting Results in an Immunocompetent Host: a Case Report and Review of Literature.” Acta Clinica Belgica 69 (4): 262–266.
Vancouver
1.
Cattoir L, VAN HENDE V, De Paepe P, Padalko E. Epstein-Barr virus serology and PCR: conflicting results in an immunocompetent host: a case report and review of literature. ACTA CLINICA BELGICA. 2014;69(4):262–6.
IEEE
[1]
L. Cattoir, V. VAN HENDE, P. De Paepe, and E. Padalko, “Epstein-Barr virus serology and PCR: conflicting results in an immunocompetent host: a case report and review of literature,” ACTA CLINICA BELGICA, vol. 69, no. 4, pp. 262–266, 2014.
@article{5792117,
  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.},
  author       = {Cattoir, Lien and VAN HENDE, VANESSA and De Paepe, P and Padalko, Elizaveta},
  issn         = {1784-3286},
  journal      = {ACTA CLINICA BELGICA},
  keywords     = {Serology,Epstein-Barr virus,PCR,Immunocompetent,Specimen type,STEM-CELL TRANSPLANTATION,POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER,POLYMERASE-CHAIN-REACTION,BLOOD MONONUCLEAR-CELLS,VIRAL LOAD ASSAYS,REAL-TIME PCR,WHOLE-BLOOD,PERIPHERAL-BLOOD,DNA LOAD,PREEMPTIVE DIAGNOSIS},
  language     = {eng},
  number       = {4},
  pages        = {262--266},
  title        = {Epstein-Barr virus serology and PCR: conflicting results in an immunocompetent host: a case report and review of literature},
  url          = {http://dx.doi.org/10.1179/2295333714Y.0000000037},
  volume       = {69},
  year         = {2014},
}

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