Diagnosis of infectious mononucleosis caused by Epstein-Barr virus in infants
Background: The diagnosis of infectious mononucleosis (IM) is usually on serologic tests. The responses of anti‐Epstein–Barr virus (anti‐EBV) antibodies are weak in infants. The authors encountered some IM infants in whom anti‐EBV antibodies were undetectable during early stage, although EBV genome...
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Published in | Pediatrics international Vol. 52; no. 4; pp. 536 - 540 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Melbourne, Australia
Blackwell Publishing Asia
01.08.2010
Blackwell Publishing Ltd |
Subjects | |
Online Access | Get full text |
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Summary: | Background: The diagnosis of infectious mononucleosis (IM) is usually on serologic tests. The responses of anti‐Epstein–Barr virus (anti‐EBV) antibodies are weak in infants. The authors encountered some IM infants in whom anti‐EBV antibodies were undetectable during early stage, although EBV genome was found in their blood. The aim of the present study was therefore to clarify the frequency of anti‐EBV‐antibody negative IM cases.
Methods: The EBV serostatus of 104 IM children diagnosed on Sumaya criteria was retrospectively studied. The EBV genome in peripheral blood mononuclear cells was measured.
Results: The anti‐viral capsid antigen‐IgM (anti‐VCA‐IgM)‐positive rate in the acute phase was only 25% in infants but 80% in patients ≥4 years of age. Twenty percent of the infants were negative for all anti‐EBV antibodies and required repeated serologic tests. For infants, the significant rise in anti‐VCA‐IgG was the most sensitive marker. Three seronegative infants with IM symptoms, with circulating EBV genome during acute phase, were eventually considered as having IM on anti‐VCA‐IgG seroconversion thereafter.
Conclusions: To diagnose IM in infants the serologic test alone in the acute phase is not sensitive enough. It is proposed that the EBV genome be evaluated in peripheral blood mononuclear cells when infants presenting with IM symptoms are negative for anti‐EBV antibodies during the acute phase. |
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Bibliography: | istex:FC050CED4175EFF6DB60C4878C9C8A80B1A36D39 ArticleID:PED3087 ark:/67375/WNG-RCQCMW3V-R ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2 |
ISSN: | 1328-8067 1442-200X |
DOI: | 10.1111/j.1442-200X.2010.03087.x |