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Apologies For The Long Paragraph, But It's A Complex Situation.

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Posted on Sun, 28 Feb 2021
Question: Apologies for the long paragraph, but it's a complex situation. Starting about 11 months ago, I began experiencing low grade fevers, a sore throat, fatigue, and other intermittent symptoms such as muscle pain, GI distress, orthostatic intolerance, and joint pain. For the past 11 months, I've seen what feels like every type of specialist under the moon, and had dozens of blood tests and imaging tests, all of which came back negative or within normal range. Yet my symptoms have shown no improvement. Only recently was I tested for EBV antibodies, which previous doctors failed to do because I had already tested positive for mono back in 2018. However, these results showed something strange. I showed no signs of VCA IgM and EBNA antibodies, and VCA IgG antibody levels at around 750, indicating
doctor
Answered by Dr. Baranidharan Kuselan (2 hours later)
Brief Answer:
Need more information

Detailed Answer:
Hi,
Thanks for posting your question.
I am Dr.Barani.
Your post appears incomplete.
What would you like to know?
Regards,
Dr.Barani
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Baranidharan Kuselan (27 minutes later)
sorry, looks like it got cut off. Here's the rest of my question:
I showed no signs of VCA IgM and EBNA antibodies, and VCA IgG levels at around 750, indicating "recent infection". However, these results are identical to my test results from 2018, meaning that I've never developed EBNA antibodies. My doctor ordered a follow-up CBC, sed rate and CRP, metabolic panel, and EBV DNA PCR. The CBC, sed rate, CRP, and metabolic panel all came back normal, but my EBV PCR showed my viral levels to be elevated at 1,300 copies/mL. The only instances of these antibody/PCR quantities I can find are in cases of CAEBV, which is very scary because of its high fatality. The published diagnostic criteria for CAEBV includes EBV DNA of >10^2.5 copies/mg, but I'm not sure how to convert this to compare my own number (given in copies/mL). So my first question is do you know how to compare my PCR result to the diagnostic criteria for CAEBV. My second question is do you have any ideas what these results could indicate? Since my inflammatory markers, CBCs, and liver tests have been normal throughout this entire illness, that doesn't really line up with CAEBV clinical presentation. However, I think that for some reason the virus isn't going completely latent, and so I'm wondering if you've ever heard of or seen anything like this before. Thanks!
doctor
Answered by Dr. Baranidharan Kuselan (9 hours later)
Brief Answer:
Need more information

Detailed Answer:
Hi,
Thanks for the details.
What symptoms you have now?
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Baranidharan Kuselan (4 hours later)
Still mainly just low grade fevers and sore throat, with some fatigue, muscle aches, orthostatic intolerance, and occasional upset stomach.
doctor
Answered by Dr. Baranidharan Kuselan (34 hours later)
Brief Answer:
Need more information

Detailed Answer:
Hi,
Can you upload the document showing the results of EBV PCR result?
I will be better able to help you after seeing the reports.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Baranidharan Kuselan

Pain Medicine & Palliative Care Specialist

Practicing since :1996

Answered : 417 Questions

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Apologies For The Long Paragraph, But It's A Complex Situation.

Brief Answer: Need more information Detailed Answer: Hi, Thanks for posting your question. I am Dr.Barani. Your post appears incomplete. What would you like to know? Regards, Dr.Barani