Epstein-Barr Virus Acute Panel
Label Mnemonic: EBVACUTE
Epic Lab Code: LAB7810
Downtime Form: A-1a General Laboratory Requisition
Chemistry
6240 RCP
356-3527
Specimen(s):
Plasma
Collection Medium:
Plasma Separator Tube 4.5 mL
Alternate Collection Media:
Pink top tube 6 mL (K2-EDTA) or Red top tube 5 mL (Clot Activator)
Minimum:
3.0 mL whole blood or TWO Microtainer® devices.
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around Time:
3 hours (upon receipt in laboratory)
Reference Range:
Reference range for both analytes (Heterophile IgM, VCA IgM): 0.8 AI or less: Negative 0.9-1.0 AI: Indeterminate 1.1 AI or greater: Positive
Interpretive Data:
This panel consists of two tests for acute EBV infection: Heterophile IgM antibodies Viral capsid antigen (IgM) antibody Epstein-Barr virus (EBV) is the etiologic agent of infectious mononucleosis. EBV infection can be difficult to diagnose by laboratory testing; however, the majority of acute infections can be recognized by testing the patient's serum for heterophile antibodies (e.g., by the "Monospot" latex agglutination assay), which usually appear within the first 3 weeks of illness, but then decline rapidly within a few weeks. Heterophile antibodies are found in a very high percentage of infants and older children with acute mononucleosis. However, heterophile antibodies do not develop in approximately 10% of adults. Presence of VCA IgM antibodies indicates recent primary infection with EBV. Infection with EBV usually occurs early in life, typically as infectious mononucleosis. Other disorders due to EBV infection have been recognized, including Burkitt's lymphoma and nasopharyngeal carcinoma. EBV infection may also cause lymphoproliferative syndromes, especially in patients who have undergone renal or bone marrow transplantation and in those who have AIDS. Acute EBV infection usually shows either: Heterophile IgM positive / VCA IgM positive or Heterophile IgM negative / VCA IgM positive Heterophile IgM is relatively less sensitive than VCA IgM in acute EBV infection. The pattern of heterophile IgM positive / VCA IgM negative is very uncommon and difficult to interpret.
Comments:
Reference:
Klutts JS et al. Evidence-based approach for interpretation of Epstein-Barr virus serological patterns. J. Clin. Microbiol. 47(10): 3204-3210.
Methodology:
Multiplex Flow Immunoassay
CPT Code:
86308 (Heterophile), 86665 (VCA IgM)