Table 5.

Supplemental findings and recommended specific laboratory tests for diagnosing CAEBV (from Okano ⁵²).

IM-like symptoms generally include fever, swelling of lymph nodes, and hepatosplenomegaly; additional complications include hematological, digestive tract, neurological, pulmonary, ocular, dermal and/or cardiovascular disorders (including aneurysm and valvular disease) that mostly have been reported in patients with IM Anti-EBV antibodies with raised anti-VCA and anti-EA ordinarily consist of VCA-IgG ≥ 1:640 and EA-IgG ≥ 1:160; positive IgA antibodies to VCA and/or EA are often demonstrated Recommended specific laboratory tests Detection of EBV-DNA, RNA, related antigens and clonality in affected tissue including the peripheral blood PCR (quantitative, qualitative) More than 10 2,5 copies /μg DNA are generally detected in peripheral blood mononuclear cells; healthy individuals occasionally show positive results by qualitative PCR analysis In situ hybridization (e.g., EBERs) Immunofluorescence etc. (e.g., EBNA, LMP) Southern blotting (including clonality of EBV) Clarifyng a target cells of EBV infection Double staining of EBNA or detection of EBER or EBV DNA with each marker for B, T, NK, cells or monocytes/ macrophage/ histiocytes is recommended by using such methods as immunofluorescence, immunohistological staining, or magnetic beads Histopatological and molecular evaluation General histopathology Immunohistological staining Chromosomal analysis Rearrangement studies (e.g., immunoglobulin, T-cell receptor) Immunological studies Generalized immunological studies Marker analysis of peripheral blood (including HLA-DR) Cytokine analysis

Abbreviations: IM: infectious mononucleosis; VCA: viral capsid antigen; EA: early antigen; PCR: polymerase chain reaction; EBERs: EBV-encoded RNAs; EBNA: EBV-determined nuclear antigen; LMP: latent membrane protein; HLA: human leukocyte antigen.