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What Does My Lab Test Report Indicate?
Posted on
Sat, 25 Feb 2017
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 25 Feb 2017
Answered on
Mon, 20 Mar 2017
Last reviewed on
Question : Hi Doctor,
Regarding these EBV results (below), do you think I had a past infection, or I'm in convalescence and still in the recovery phase ?
Lab tests were done a week ago, I have a high lymphocyte count (53%, absolute 5.8 compared to 3.1 as normal high) and high WBC (11.1 compared to 10.8 as normal high) the other results where normal and I tested negative for Strep, Throat culture showed nothing abnormal even if I have mild pain in my throat, but what is scaring me the most is swollen lymph nodes under my chin where my neck starts and in the left side of my neck in the clavicula triangle (which I read is no good). I have low grade fever most of the nights (98.9 / 99 F) but I had a fever with chills (101 F) about 1 month before the blood work was done. I'm trying to find an explanation to my symptoms. How probable is it that it is EBV that's causing all these symptoms regarding these results ?
EBV Ab VCA, IgM <36.0 U/ml NEGATIVE
EBV Early Antigen Ab, IgG <9.0 U/ml NEGATIVE
EBV Ab VCA, IgG 180.0 U/ml HIGH (Positive >21.9)
EBV Nuclear Antigen Ab, IgG >600.0 U/ml HIGH (Positive >21.9)
NOTE : I don't know if I have been infected with the virus in the past
I attached full lab results.
Thanks.
Regarding these EBV results (below), do you think I had a past infection, or I'm in convalescence and still in the recovery phase ?
Lab tests were done a week ago, I have a high lymphocyte count (53%, absolute 5.8 compared to 3.1 as normal high) and high WBC (11.1 compared to 10.8 as normal high) the other results where normal and I tested negative for Strep, Throat culture showed nothing abnormal even if I have mild pain in my throat, but what is scaring me the most is swollen lymph nodes under my chin where my neck starts and in the left side of my neck in the clavicula triangle (which I read is no good). I have low grade fever most of the nights (98.9 / 99 F) but I had a fever with chills (101 F) about 1 month before the blood work was done. I'm trying to find an explanation to my symptoms. How probable is it that it is EBV that's causing all these symptoms regarding these results ?
EBV Ab VCA, IgM <36.0 U/ml NEGATIVE
EBV Early Antigen Ab, IgG <9.0 U/ml NEGATIVE
EBV Ab VCA, IgG 180.0 U/ml HIGH (Positive >21.9)
EBV Nuclear Antigen Ab, IgG >600.0 U/ml HIGH (Positive >21.9)
NOTE : I don't know if I have been infected with the virus in the past
I attached full lab results.
Thanks.
Brief Answer:
EBV not likely...
Detailed Answer:
Hello,
your tests are negative for current infection (acute primary which is common or reactivation which is rare) with EBV. Neck nodes are usually enlarged and tender during the course of upper respiratory tract infections. Sore throat is another common symptom. More serious causes that have to be excluded include HIV and tumors. The low ESR and negative ANA are against autoimmune disorders although they're not conclusive.
For how long has these symptoms been going on? Did you receive any treatment? If it's more than 1-2 weeks then an ultrasound scan may provide additional clues for the lymph nodes.
Kind Regards!
EBV not likely...
Detailed Answer:
Hello,
your tests are negative for current infection (acute primary which is common or reactivation which is rare) with EBV. Neck nodes are usually enlarged and tender during the course of upper respiratory tract infections. Sore throat is another common symptom. More serious causes that have to be excluded include HIV and tumors. The low ESR and negative ANA are against autoimmune disorders although they're not conclusive.
For how long has these symptoms been going on? Did you receive any treatment? If it's more than 1-2 weeks then an ultrasound scan may provide additional clues for the lymph nodes.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have been having these symptoms for about a month now, I took a full course of amoxicillin 10 days, plus another 10 days of levaquin, throat pain is dissipating now, I only feel it a couple times a day sometimes not and I have no difficulty eating, laryngoscopy showed nothing abnormal in my throat.
I'm on prednisone right now 40mg a day and ibuprofen 800mg 3 times a day.
Regarding HIV, I had a 4th generation test done 1 month after my last sexual encounter and tested negative. I read that 4 weeks is virtually conclusive for this type of test, should I take another one ?
I also had chest x-rays and doctor said nothing abnormal there.
I'm scheduled for a neck CT scan this week, my ENT want to have a clear look at what's happening in my neck because it's tender and because of my swelling above clavicula. I'm looking for some reassurance if I can find any ... Everything I read on the internet points toward malignency. I'm also a smoker, I stopped when my symptoms begin.
The cervical lymphadenopathy is not without pain, I feel some discomfort I'm just not sure it comes from the nodes or the surrounding tissue, also it's not bilateral some are in right side (submandibular) some in my left (supraclavicular)
Can you shed some light on the overall picture, and if I should be worried or if it's not that uncommon ?
Thanks doctor.
I'm on prednisone right now 40mg a day and ibuprofen 800mg 3 times a day.
Regarding HIV, I had a 4th generation test done 1 month after my last sexual encounter and tested negative. I read that 4 weeks is virtually conclusive for this type of test, should I take another one ?
I also had chest x-rays and doctor said nothing abnormal there.
I'm scheduled for a neck CT scan this week, my ENT want to have a clear look at what's happening in my neck because it's tender and because of my swelling above clavicula. I'm looking for some reassurance if I can find any ... Everything I read on the internet points toward malignency. I'm also a smoker, I stopped when my symptoms begin.
The cervical lymphadenopathy is not without pain, I feel some discomfort I'm just not sure it comes from the nodes or the surrounding tissue, also it's not bilateral some are in right side (submandibular) some in my left (supraclavicular)
Can you shed some light on the overall picture, and if I should be worried or if it's not that uncommon ?
Thanks doctor.
Brief Answer:
probably benign but investigation is required
Detailed Answer:
You're welcome!
I agree with the investigation done so far and the CT scan. The CT scan is the best way to look at the lymph nodes although an ultrasound scan wouldn't have gone amiss because it may provide additional details like blood flow in the nodes. There are certain characteristic changes when a node is malignant in the ultrasound scan. The CT will describe all the nodes in the area. Enlarged liver and spleen can be detected with clinical examination but an ultrasound scan (or CT scan) of the abdomen is a more accurate way to find out.
Tenderness is usually present when the nodes are of inflammatory origin (infectious usually), so this is a good sign. No clinical sign is conclusive though. The only 99% certain way to find out is by removing the node and examining it under microscope (biopsy). If there are no signs of malignancy though, perhaps a better strategy would be monitoring.
One month after a suspicious exposure is adequate time for 4th generation HIV testing and it has to be considered conclusive. If you'd like to have 100% piece of mind you can repeat the test a couple of weeks later.
Having symptoms for so long is not common. In most cases the symptoms last for about a week. More protracted disease can be caused by some viruses like EBV, CMV, HIV, HBV, etc which may all cause the mononucleosis syndrome.
I hope I've answered your question. Stay calm as the odds are against malignancy; you should complete the investigation though.
Kind Regards!
probably benign but investigation is required
Detailed Answer:
You're welcome!
I agree with the investigation done so far and the CT scan. The CT scan is the best way to look at the lymph nodes although an ultrasound scan wouldn't have gone amiss because it may provide additional details like blood flow in the nodes. There are certain characteristic changes when a node is malignant in the ultrasound scan. The CT will describe all the nodes in the area. Enlarged liver and spleen can be detected with clinical examination but an ultrasound scan (or CT scan) of the abdomen is a more accurate way to find out.
Tenderness is usually present when the nodes are of inflammatory origin (infectious usually), so this is a good sign. No clinical sign is conclusive though. The only 99% certain way to find out is by removing the node and examining it under microscope (biopsy). If there are no signs of malignancy though, perhaps a better strategy would be monitoring.
One month after a suspicious exposure is adequate time for 4th generation HIV testing and it has to be considered conclusive. If you'd like to have 100% piece of mind you can repeat the test a couple of weeks later.
Having symptoms for so long is not common. In most cases the symptoms last for about a week. More protracted disease can be caused by some viruses like EBV, CMV, HIV, HBV, etc which may all cause the mononucleosis syndrome.
I hope I've answered your question. Stay calm as the odds are against malignancy; you should complete the investigation though.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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