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Cytomegalovirus CMV diagnosis help

I'm hoping someone can shed light on my contradictory blood results.

CMV  IgG   > 10       range > 0.69 is high
CMV  IgM   > 62.5    range > 34.9 is positive

I present with extreme fatigue, malaise, low grade fever, swollen salivary glands on my worst days.  Like my immune system is fighting a virus.  This seemed to occur after receiving several pints of transfusion blood during surgery.

However, infectious disease doctor says I don't have active infection because PCR CMV came back undetectable.  I've read conflicting information about the sensitivity, timing and interpretation of these tests when viewed together.

Can anyone offer some input?  I need to find out what is wrong so I can fix it.

Thanks!
2 Responses
1415174 tn?1453243103
COMMUNITY LEADER
Hi, Well, it could be that you have a transfusion reaction or an infection from the transfusion. Some of the symptoms include fever, anemia (despite getting blood), and fatigue, chills, back pain, skin flushing etc. Or you may just have a virus. It can occur several days after the transfusion. How long has it been since the transfusion? If it has been weeks then it is not likely. The results you gave shows both the IgG was positive as well as the IgM.  This means that it is a past infection. So you have immunity to it.  >10 just means anything above ten so it was positive otherwise the result would have been <10. Most people have had both Herpes and CMV by the time they are adults. So it is not likely to be a new infection from that. So if you had a recent transfusion I would report your symptoms to the doctor that ordered the transfusion. I'm surprised the doctor didn't say anything about this. Did he not know you had recently had all this done? If he did perhaps it is more likely a regular virus. it will pass. But the extreme fatigue makes me think you could be iron deficient or still low in blood or a reaction to the transfusion like I said. I would still see another doctor or have them check your blood and do a complete blood count at least.
mkh9
2 Comments
Thanks for your response. I don't think symptoms were immediately related to the transfusion process, just that the CMV might have been contracted during it. The transfusion was in Dec 2013 and I became very symptomatic in February 2015.  Bottom line is I'd like to know if I have a reactivation or active infection as shown by pair of high serum samples IgG and IgM -- despite a negative PCR CMV.
It is hard to know if it was from the transfusion but it is unlikely because usually you would have symptoms about 2-4 weeks after the transfusion.  About 90% of adults have EBV, CMV and Herpes by the time they are an adult. Any of these could reactive when your immunity is lowered. So, the results could be a reactivation since your IgM was positive. Usually with an old infection the IgM would be negative and the IgG positive.
Hope this helps.
mkh9
1415174 tn?1453243103
COMMUNITY LEADER
Hi, Well, it could be that you have a transfusion reaction or an infection from the transfusion. Some of the symptoms include fever, anemia (despite getting blood), and fatigue, chills, back pain, skin flushing etc. Or you may just have a virus. It can occur several days after the transfusion. How long has it been since the transfusion? If it has been weeks then it is not likely. The results you gave shows both the IgG was positive as well as the IgM.  This means that it is a past infection. So you have immunity to it.  >10 just means anything above ten so it was positive otherwise the result would have been <10. Most people have had both Herpes and CMV by the time they are adults. So it is not likely to be a new infection from that. So if you had a recent transfusion I would report your symptoms to the doctor that ordered the transfusion. I'm surprised the doctor didn't say anything about this. Did he not know you had recently had all this done? If he did perhaps it is more likely a regular virus. it will pass. But the extreme fatigue makes me think you could be iron deficient or still low in blood or a reaction to the transfusion like I said. I would still see another doctor or have them check your blood and do a complete blood count at least.
mkh9
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