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EBV Lab Results Question
I've been running a low grade fever for almost 3 months now. My doc did all kinds of labs (including autoimmune labs which were negative) and all of my CBC's have come back normal. He FINALLY tested me for Mono 2 weeks ago after being sick all this time. When the test came back, they told me I have Mono, but then when I asked if it was active Mono, they said they didn't think so. I then faxed my results to a family friend (an ER doc) and he said it looked like I had it, but might be in the convalescence phase right now. Well I'm still running a low grade fever and feel yucky. From my results below, do you guys think that Mono is what has had me down for the last 3 months? I've felt extremely tired, achy, but have not had the sore throat and no swollen lymph nodes that I could tell. I'm being told to wait this out, but don't want to wait if it's not Mono and could be something else- it's driving me crazy wondering!!! Also, do you still run a fever in the convalescence phase (I am)?
Here are my labs:

EBV Panel Interpretive Table:
CLINICAL STAGE                VCA-IgG    VCA-IgM    Early AG     EBNA
----------------------------------------------------------------------------------------------------------
Never infected                         -                 -                -                 -
Acute Infection                       +                 +               +/-              -
Convalescence                       +                +/-               +              +/-
Recent Past Infect                  +                 -                +/-              +
Remote Past Infect                 +                 -                 -                +
Chronic Infect                         +                 -                 +               +/-

EBV Early AG IgG   <5.0    (Normal range 600.0 (High)     (Normal range <18.0)

EBV VCA IgG  71.7 (High)      (Normal range <18.0)

EBV VAC IgM  <10.0       (Normal range <36.0)


Comprehensive Metabloic Panel labs all normal except:
Lymphocytes 13 (L)
Neutrophils 82 (H)
WBC 9.8- Normal



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1415174 tn?1453246703
Hi, well I have some questions:
What was your EBNA result? I don't see it here.
For the EBV AG IgG, you have both 600 and <18.0 which one is the normal range?
Usually you have an increase in the atypical lymphocytes and they are not low like yours are. Also, the Neutrolphils are high showing it may be a viral or bacterial infection. Sometimes a viral infection actually lowers the WBC count.  I still need the answers to these questions in order to make a decision though.
Also, your IgM was negative so it doesn't sound like a very recent infection. With EBV you usually have the sore throat and swollen lymph nodes and a high fever . I haven't seen one without these two clinical findings being absent as it is part of the diagnosis to have these symptoms. So, now the question is are you in the recovery stage or were you exposed a long time ago and still have IgG antibodies. That is what I want to confirm before answering your question. Did they ever do a mono spot test on you?
mkh9
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1415174 tn?1453246703
Also, did you ever have a high fever or was it always low grade? Have they tested you for other viruses or what other tests have you had other than the autoimmune trests and CBC? Any cultures taken ? EBV does take 2-3 months to get over. So, it is possible to have a lingering fever. Some people normally have low grade fever or if you take your temperature at night or late in the day it may be low grade normally. Meaning your temperature usually is lower in the morning then goes up in the evening.
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Thank you for your response. I don't know why the labs showed up all skewed.
Here are the correct results;
EBV early AG IgG: 600 (high)
EBV VCA IgG 71.7 (high)
EBV VCA IgM: <10 (normal)

The doc didn't do a mono spot test.

What they've done so far:
labs- only abnormals were posted above in my first post
EGD- negative
Sinus CT- normal
Chest X ray- normal
Abdominal ultrasound- normal
ANA- normal
Lupus test- normal
Rhuematoid- normal

They have not drawn cultures yet, but I'm going to ask him to Monday. Does this sound like recent mono or old mono? I've been really exhausted for a while and run a 99.6-100 temp each day. I'm scared because they're not finding anything so I'm worried that there's something bad going on. I know I should be positive, but it's hard when I've been sick for so long. I always seem to think the worst like cancer or something. Hopefully that won't be the case. Can you think of anything else for them to test?
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It's still not showing up right! Ugh!

Ebv early AG igg- 600 high

Ebv vca igg- 71.7 high

Ebv vca igm- <10 normal
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Ok, I don't know what the problem is. I keep posting my labs and double checking and it keeps messing my results up so I'm going to try it this way.
My ebb early ag igg is less than 5 which is normal.
My ebv nuclear antigen is greater than 600 which is high
My ebv vca igg is 71.7 which is high
My ebv vca igm is less than 10 which is normal.
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1415174 tn?1453246703
Hi, so by these results you just gave me you have a past infection of EBV. It isn't a primary infection or reactivation.. So you don't have mono now. It is possibly another virus, or you could have chronic fatigue syndrome from a past infection of EBV or something else. Do you have night sweats, and a cough? Any other symptoms than what you have mentioned?
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Thank you for your response. I've had 2 docs tell me different on the mono. I don't have a cough, but do occasionally have night sweats.
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Oh, my ribs on my left side have also been a little tender. Other than that, no pain really. Just fever and exhaustion :(
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1415174 tn?1453246703
Have you been tested for TB lately? Also, it could still be a virus or even EBV that is giving you chronic fatigue. I assume they listened to your lungs? In my opinion I think you had Mono a long time ago. EBV results are indicating that and your current symtoms don't show that it was recent. But like I said it is possible that you have reactivation of the EBV virus but usually your early antigen would be positive if that was the case....
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My lungs are clear. Hopefully this is just a virus that'll pass. I've just never been sick like this in my life so it's hard to take in. 3 months of misery has been enough for me. I have another doctor's appointment tomorrow so hopefully he'll be able to figure something out this time. Thank you for all of your suggestions :)
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I realize this thread is old.  I'm wondering whatever happened.  I have had low grade fevers for the past three months and my mono test results were very similar to yours.  Any info you can give me will be appreciated!
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I have been feeling very yucky for awhile now.  Very little energy sore throats swollen lymph nodes stomach problems body aches joint paims. Have been seeing gastrointestinal specialist and my blood work had him a little worried so he check for ebv and results where my vca igG > 750 lgm negative ag nuclear > 600.  Which I understand this means I have had a past infection which I knew I have but that was over 13 years ago.  So why are my levels so high off the charts?
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1415174 tn?1453246703
Sorry you have been ill. The high antibody levels just mean you have a good immune system. Have you had any high fever with the sore throat? Any pus in the throat? Have you been bitten by a tick? Any rash? Have you been hiking before this? Have you traveled out of the country lately?
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Yes I have had a low grade fever no rash or pus. Haven't been out of the country in a few years.  I been diagnosed with gastritis with active bleeding negative biopsies.  My wbc and lypmphocytes were also elevated.  My dr is sending me to cancer specials mid month.
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I have had lesions on scalp for years and have been feeling horrible for years, had blood work done and it showed &gt; 600 for Epstein Barr virus. I am now having blister lesions on scalp.. have been to infectious disease doctors and dermatologists and no real treatment, I&#39;m desperate in finding a treatment for what&#39;s making me feel horrible and the pain and burning sensation on the scalp. Please help!
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1415174 tn?1453246703
Well you don't have mono, and it doesn't sound like strep throat. You could get tested for Lyme just in case. So you were negative for Helicobacter pylori? I assume they tested you for this bacteria if they did a biopsy of the stomach on a gastroscopy or something like that? How high were the WBC and Lymphocytes?
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Yeah it was negative for the bacteria.  I did find a tick on me early spring but was already feeling ill. My wbc was athe 12.4 and lymphocytes 4.3.  It's been elevated for about a year now.  It will come down a little bit but shoots back up. I have read having off the chart vca igg can be a sign of multiple melanoma or ms.  
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1415174 tn?1453246703
EBV VCA IgG can remain positive in about 20% of people. So I wouldn't worry about that. Your WBC count isn't that high. It is considered normal in a lot of labs. What is your reference range? Same for the lymphocytes what is the reference range for those. 4.3 isn't that low either. Certainly, doesn't sound like leukemia. That would very high usually 20.0 or more.

If I were you since you did see a tick you may not have seen  a tick that bit you. This would cause the lab values if you had lyme. You may want to get tested. The best test is a PCR test at a lab called IgeneX. If you could get your lab work sent there they have a multiplex test. Just a thought. If you can't do that then at least get tested.

I have seen people with H. pylori who got a biopsy and it was negative. The gold standard is actually a urea breath test. So you may want to get that done. You have to be fasting and they tell you what to do. That would also give you all the symptoms you are having.

mkh9

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Thanks for the info.  I do have a lot of symtoms of Lyme disease.  I see the blood dr in a couple weeks.  Just tired of being tired and feeling this way.  I know the wbc isnt really high but it's higher then the lab values but not by much I think it's 10.7.  Not sure about the lymphocytes.  I did take the breath test before and it was negative also.
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1415174 tn?1453246703
Well, that is great that you were urea breath test negative for H. pylori. That rules that out then. So, I guess check for lyme. I mentioned the multiplex because there are some new species of lyme that the usual test does not pick up. That is why I mentioned that particular laboratory. Your doctor's office could see their blood drawing requirements and ship it there. But you may have to pay cash for it and so that may be too expensive for you I don't know.
Let me know how it goes.
Take care
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