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Epstein Barr Virus Antibody to Viral Capsid Antigen, IgM

EBV VCA IgM, EBV IgM, Epstein-Barr Virus IgM

Test Codes

EPIC: LAB5831, SOFT: EBVM

Department

Special Chemistry

Specimen Collection Criteria

Collect: One Gold-top SST tube. (Minimum Whole Blood: 2.0 mL)

Physician Office/Draw Specimen Preparation

Preparation for Courier Transport

Transport: Centrifuged collection tube, refrigerated (2-8°C or 36-46°F). (Minimum: 0.5 mL)

Rejection Criteria

Plasma specimens. 

Severely lipemic, icteric, or grossly hemolyzed specimens. 

In-Lab Processing

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Room temperature is acceptable for a maximum of twelve hours. (Minimum: 0.5 mL)

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes, Red-top Tubes, and Microtainers^®
Room Temperature (20-26°C or 68-78.8°F): 12 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 12 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Royal Oak Special Testing Laboratory

Performed

Monday – Friday.
Results available within two business days.

Reference Range

Negative.

Test Methodology

Indirect Chemiluminescent Immunoassay (CLIA).

Interpretation

The EBV IgM results should be evaluated in relation to the patients symptoms, clinical history, and other laboratory findings to establish a diagnosis.

False negative results may occur if the specimen is drawn in the early stages of infection.

Negative results may be obtained if the specimen is drawn late during the acute phase, when anti-viral capsid IgM is no longer present.

For definitive serodiagnosis, concurrent testing for antibody responses to other EBV antigens such as early antigen (EA) and nuclear antigen (EBNA) is recommended.

The EBV IgM assay is a qualitative test, test results should be considered positive or negative for the presence of IgM antibody to EBV VCA.

Clinical Utility

The EBV IgM assay is used for the qualitative detection of IgM antibody to the viral capsid antigen (VCA) of EBV. EBV-VCA IgM is first detectable 2-4 weeks after primary infection. IgM is usually present at peak amounts at the onset of clinical symptoms. Antibody levels are usually not detectable 2-3 months after the symptoms subside.

Clinical Disease

Epstein-Barr virus (EBV) is the etiological agent of infectious mononucleosis and has been implicated in African Burkitt's lymphoma and nasopharyngeal carcinoma.

Childhood infections may be asymptomatic or produce "flu-like" illness. Adolescents and adults who escape infection during childhood experience infectious mononucleosis (IM). IM is characterized by irregular fever, pharyngitis, and lymphadenopathy lasting 1 to 4 weeks. Hematological abnormalities include an absolute increase in lymphocytes and monocytes exceeding 50% and more than 15% atypical lymphocytes, lasting for at least 2 weeks. Liver function tests generally reveal a mild to moderate increase in SPGT, SGOT, bilirubin, and LDH levels. IM is usually a benign and self-limited disease. Complications including splenomegaly and splenic rupture, hepatitis, pericarditis, myocarditis, or central nervous system involvement (Guillain-Barre syndrome, Bell's palsy, transverse myelitis, and meningoencephalitis) may occur following IM infection. (1)

Epidemiology

EBV occurs throughout the world and more than 90% of adults have IgG antibodies to the virus. Most individuals acquire EBV early in life. Seroepidemiologic studies have indicated that 50% of children have antibodies to the virus by the time they are 5 years of age. No seasonality has been demonstrated. (1)

Incubation Period

The incubation period is 4–7 weeks. (1)

Transmission

EBV is poorly contagious. Transmission is via salivary contact, either through kissing or by exposure to contaminated eating implements. (1)

Reference

1. Wiedbrauk D, Johnston SLG. Manual of Clinical Virology, Raven Press, New York, NY, 1993.

CPT Codes

86665
LOINC: 5159-9

Contacts

Last Updated

1/11/2023