[CIS PIDD] [cis-pidd] EBV infections

[CIS-PIDD]

Greetings,

I recently saw a 14-year-old girl who has had classical/typical EBV
infection on 2 occasions (the latter with only an equivocal EBV VCA IgM
though).  She is now back to her normal healthy state.  Past medical
history is otherwise notable only for mild persistent asthma, allergic
rhinitis, and molluscum contagiosum on a few occasions.

What seems odd to me is that she does not have any protective antibodies to
EBV >3 months after the last infection.  I am reaching out to see if I am
missing something?


   - Infection #1.
      - 11/2014:  EBV VCA IgM positive, EBV Early Antigen IgG positive.
      Rest negative including EBV VCA IgG, EBV Nuclear Antigen IgG.
   - Infection #2.
      - 5/17/16: EBV VCA IgM 38.9 (equivocal).  Rest negative including EBV
      Early Antigen IgG, EBV VCA IgG, EBV Nuclear Antigen IgG.  CBC and CMP
      unremarkable.
      - 5/26/2016:  EBV VCA IgM 39.7 (equivocal), EBV VCA IgG 26.6
      (positive). Others were negative including EBV Early antigen IgG and EBV
      Nuclear Antigen IgG.  IgG 1106, IgA 176, IgM316,and IgE 14.
   - Present time/healthy.
      - 9/22/16:  Negative EBV VCA IgM and IgG, EBV Nuclear Antigen IgG
      negative.  Early antigen not done.

I am very grateful in advance for any thoughts on how to interpret this
scenario and next step to take (if any).


Cindy Salm Bauer, MD
Division of Allergy and Immunology, Department of Pediatric Pulmonology
Phoenix Children's Hospital
Clinical Assistant Professor, Department of Child Health, University of
Arizona College of Medicine
1919 East Thomas Road
Phoenix, AZ  85016
Office:  602-933-4063
Fax:  602-933-2423

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