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

[Boyce, Thomas G., M.D.]

Yes I suppose this is possible but then one should have evidence of persistent detection of the organism, not just antibody.

On Oct 10, 2013, at 6:57 AM, "Prescott Atkinson, M.D." <PAtkinson at peds.uab.edu<mailto:PAtkinson at peds.uab.edu>> wrote:

Hi Tom:

Persistent IgM, particularly in the case of M. pneumoniae, has also been interpreted as persistent antigenic stimulation from chronic infection, not a false positive.

Prescott


From: Boyce, Thomas G., M.D. [mailto:Boyce.Thomas at mayo.edu]
Sent: Wednesday, October 09, 2013 9:30 PM
To: CIS-PIDD
Subject: Re: [cis-pidd] Persitently elevated EBV IgM

Jason,

This is pretty common. Even at our lab at Mayo.

Sometimes it is in patients who have lots of positive IgMs to other things, presumably from nonspecific immune activation.

But most commonly it is probably just a persistent false positive IgM. We see this with other pathogens as well, most notoriously CMV and mycoplasma.

You can spend a lot of money on these patients or you can just tell them they're normal.

Tom

Thomas G. Boyce, MD
Mayo Clinic
Pediatric Infectious Diseases and Immunology

On Oct 9, 2013, at 3:42 PM, "Jason Raasch" <jraasch at midwestimmunology.com<mailto: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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