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CASE REPORT
Year : 2020  |  Volume : 40  |  Issue : 2  |  Page : 92-95

Multiple interferences of serologic studies in an Epstein–Barr virus-related infectious mononucleosis


1 Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei; Department of Pathology and Laboratory Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
2 Division of Endocrinology and Metabolism, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
3 Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Correspondence Address:
Cherng-Lih Perng
Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, No. 325, Sec 2, Chenggong Road, Neihu District, Taipei City 11490
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmedsci.jmedsci_80_19

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Epstein–Barr virus (EBV) infection is a common infectious disease in young adults and children. A 4-year-old boy was presented with enlarged tonsils and purulent discharge. Sudden airway collapse and desaturation were noted, and endotracheal tube intubation was performed. The laboratory data demonstrated positive results for EBV immunoglobulin M (IgM). Polyclonal B-cell activation that led to positive results for cytomegalovirus (CMV) IgM and herpes simplex virus (HSV) IgM was also detected by the interference of heterophilic antibodies. A low-dose intravenous immunoglobulin (IVIG) infusion was performed, and an IVIG-related false-positive result for CMV immunoglobulin G (IgG) was observed. After the aggressive medical care, the boy was discharged under a stable condition. Herein, we report the important features of EBV-related infectious mononucleosis that harvested multiple interferences. First, the heterophilic antibodies caused due to polyclonal B-cell activation resulted in the false-positive result for CMV IgM and HSV IgM. Second, the IVIG interpreted the CMV IgG. We must be aware of the multiple interferences that could misinterpret our laboratory data.


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