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

[Junker, Anne]

Along the lines of ruling out cross-reactive or non specific IgM-seroreactivity, were any tests done for IgM against other pathogens notorious for such, as hepatitis or mycoplasma, or other herpes group viruses esp. CMV?   Anne


Anne K. Junker, MD
Associate Professor and Associate Director, Faculty Affairs, Department of Pediatrics
Director, Clinical Immunology Service, BC Children's Hospital
Co-Chair, Canadian Child & Youth Health Coalition
Director, Maternal Infant Child Youth Research Network of Canada/Reseau de Recherche en Sante des Enfant et des Meres (MICYRN)
K4-223 4480 Oak Street
Vancouver, British Columbia
Canada  V6H 3V4
phone: 604-875-3591
fax: 604-875-2414
email: ajunker at cw.bc.ca



From: Cunningham-Rundles, Charlotte [mailto:charlotte.cunningham-rundles at mssm.edu]
Sent: Wednesday, October 09, 2013 3:27 PM
To: CIS-PIDD
Subject: Re: [cis-pidd] Persitently elevated EBV IgM

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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