Infectious Mononucleosis (EBV) Flashcards
Self-limiting disease caused by EPSTEIN-BARR VIRUS
Infectious Mononucleosis
confused with:
Diphtheria
Pharyngitis
Vincent’s Angina
Lymphadenitis
Scarlet Fever
Hepatitis
Pertussis
Infectious Mononucleosis
Classis symptoms of Infectious Mononucleosis:
Fever
Lymphadenopathy
Sore throat
MOT of Epstein-Barr Virus
Saliva
Blood Transfusion
Transplacental
EBV infects
B cells
Lymphocyte produce in response to the EBV infection has same characteristics with
T cell
EBV infection acquired from blood transfusion is known as
IM Postperfusion Syndrome
Other associated conditions in EBV
Burkitt’s Lymphoma
Nasopharyngeal Carcinoma
Initial infection of EBV usually manifest in
Oropharynx
EBV can integrate into DNA genome and transform to
malignant cells
Enlarged Lymphocytes with atypical nuclei
Downey cells
Antibodies that cross-react in the group of similar antigens found in unrelated animals and microorganisms
Heterophile antibodies
Usually appears in the acute phase of IM
IgM
Heterophile antibodies cross reacts with
Horse
Ox
Sheep’s RBC
Heterophile antibody are absorbed by
Beef erythrocytes
Heterophile antibody are NOT absorbed by
Guinea pig kidney cells
DOES NOT react with EBV-specific antigen
Heterophile antibody
Serological Test for IM:
Principle: Hemagglutination
Screening Test only
Px serum + Sheep’s RBC
Paul-Bunnel Screening Test
In Paul-Bunnel Screening Test; Heterophile Antibody titer is reported as the
Reciprocal of the HIGHEST DILUTION showing agglutination
Normal titer in Paul-Bunnel Screening Test
< 56
Differentiate Heterophile Antibodies found in IM, Serum Sickness, Forssman Antigen
Davidsohn Differential Test
Davidsohn Differential Test observe absorption with (2)
Guinea Pig Kidney Cells
Beef RBC’s
Davidsohn Differential Test observe agglutination with
Sheep’s RBC
Absorbed by Guinea Pig Kidney Cells and Beef RBC
Serum sickness
Absorbed by Guinea Pig cell and NOT ABSORBED BY BEEF RBC
Forssman antigen
NOT ABSORBED BY Guinea Pig Cell but ABSORBED BY BEEF RBC
Infectious Mononucleosis
Do not observed Guinea Pig Kidney cells
IM
Do not observed Beef RBC
Forssman antigen
Guinea Pig Kidney (-) ; Agglutinate with Sheep’s rbc
Infectious mononucleosis
Beef’s RBC (-) ; Agglutinate with Sheep’s RBC
Forssman antigen
Also a differential Test but requires absorption of Patient’s serum
Monospot Test/Rapid Differential Slide Test
In Monospot Test/ Rapid Differential Slide Test it is uses to agglutinate with Heterophile antibodies
Horse RBC
detectable in the early course of Infection
IgM Anti-VCA
Detectable AFTER SHOWING SIGNS AND SYMPTOMS
May persist for Life
IgG Anti-VCA
Strongly indicates ACTIVE INFECTION
Reactivation of Latent Infection
Not consistent indicator of EBV
IgG Anti-EA-D
Found in the serum of very young children but NOT IN YOUNG ADULTS
IgG Anti-EA-R
found in the nucleus of ALL EBV-infected cells
Does not stimulate antibody until after incubation of IM
EBNA
appears during convalescence
Anti-EBNA
EBNA stands for
Epstein Barr Nuclear Antigen
VCA stands for
Viral Capsid Antigen
Have a higher level of specificity and are considered GOLD STANDARD OF EBV SEROLOGIC METHOD
Indirect Immunofluorescence assays (IFA)