효소면역검사법상 EBV VCA IgM 양성 결과를 보인 예들에 의한 ImmunoDot 추가검사 및 임상상 고찰을 통한 효용성 검토

Abstract

Serologic testing is the method of choice for the diagnosis of Epstein-Barr virus(EBV) infection. Effective laboratory diagnosis is generally made using sample by measuring antibodies to a panel of EBV-associated antigens by enzyme immunoassay. However, antibodies are usually acquired earlier in life. Therefore, it is highly recommended that positive results of VCA IgM in adult be retested by other methods. A total of 851 samples were tested for EBV antibody panel by EIA(EBV VCA IgM ELISA, IBL Hamburg, Germany). Positive samples were retested by ImmunoDot (GenBio, CA, USA) and clinical review for those patients was done. 26 of 851(3.1 %) sample were VCA IgM positive by EIA. However, 25 samples showed negative reaction by ImmunoDot test. No clinical sympyoms were noted for 20 patient who were in pre- or post-transplantation state. EBV panel tests were one of routine protocol for transplantation in our hospital. another 5 cases were to have suffered from FUO (8 years), cervical lymphadenopathy(5 years), SLE(36 years), adult onset still‘s disease(36 years), and elevated liver enzyme during the treatment of of medulloblastoma(12 years). these patient were not finally recorded to have EBV infection. clinical presentation of only one case(27 years), who showed positive reaction in both EIA and ImmunoDot, was compatible with EBV infection, in whom fever, cervical lymphadenopathy, acute pharyngitis and splenomegaly, elevated AST/ALT(211/644 IU/L), and atypical lymphocytosis(29 %) were noted. only this patient was chated to be diagnosed as infectious mononucleosis by EBV. We concluded that supplemental test for EBV VCA IgM by ImmunoDot (Genbio, CA, USA) was useful. Considering that most Koreans are infected with EBV earlier in life, supplemental test by other methods is to be necessary in cases showing VCA IgM positivity in Korea.