[CIS PIDD] [cis-pidd] Persitently elevated EBV IgM

[Cunningham-Rundles, Charlotte]

Hi,

In my experience, the commercial labs do not necessarily  buy polyclonal reagents that only detect  IgM.  The absorption step is supposed  to get all the  IgG   out  but it does not.  So it is not really  mu chain specific.   Quest is famous for this and I assume others will have the same issue.    Send to a reference lab before you get into a lot of other testing.   Especially as the DNA is not found and you are not really suspicious.

I have a few referrals every  year for this cross reactively.

Charlotte


On 10/9/13 4:39 PM, "Jason Raasch" <jraasch at midwestimmunology.com> wrote:

Appreciate your thoughts/opinions:

In a patient (any age) who's basic immune evaluation for recurrent respiratory illness is unremarkable, how convinced are you that a persistently positive EBV VCA IgM (in the presence of EBV VCA IgG +/- EBNA) indicates chronic EBV infection or carrier status?  What if EBV PCR from peripheral blood is negative?

In other words, in your experience what is the SPECIFICITY of a persistently positive EBV VCA IgM ?  Are there some individuals who just never down-regulate EBV VCA IgM expression?

Thanks for your thoughts.

-Jason



Jason Raasch, MD

Midwest Immunology Clinic
15700 37th Ave N, Ste 110
Plymouth, MN 55446

TEL: (763) 577-0008
FAX: (763) 577-0192

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