Description
Infectious mononucleosis is an acute lymphoproliferative disease that is common in children and young adults and is caused by the Epstein-Barr virus. The EBV is one of the herpes viruses 4 (gamma).
Characteristic clinical features include:
1. fever, sore throat, and lymhadenopathy,
2. an associated absolute lymphocytosis greater than 50 % containing at least 10 % of atypical lymphocytes in the peripheral blood,
3. development of transient heterophil and persistent antibody responses against EBV,
4. and abnormal liver function tests.
4% of infected young adults show an icteric manifestation and 50 % have splenomegaly. In addition, EBV is implicated in Burkitt lymphoma, nasopharyngeal carcinoma and Hodgkin´s disease.
A syndrome similar to infectious mononucleosis can be caused by cytomegalovirus, toxoplasmosis and other viral infections. Therefore the differential diagnosis is of major importance. Serological tests like EIA are very useful for the detection of anti-EBV IgG and IgM antibodies, especially in cases where heterophil antibodies are absent. In a fresh infection IgM antibodies against VCA and EA are determined by immunofluorescence or ELISA. Later on VCA IgG appear followed by EBNA-1 IgG antibodies. Correspondingly the simultaneous activation of VCA IgM and EBNA-1 IgG indicates a reactivation of an EBV infection. The CD EBV (EA) IgG ELISA is helpful to monitor convalescence and reactivated infections as well as the detection of the nasopharynx carcinoma and Burkitt Lymphoma. Immune responses to the nasopharynx carcinoma and chronic reactivated EBV infections can be characterized with the help of the CD EBV (EA) IgA ELISA