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What does this blood test results regarding mononucleosis indicate?

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Dr. Prashant Sharma

Oncologist, Surgical

Practicing since :2003

Answered : 177 Questions

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Posted on Mon, 4 Aug 2014 in Infections
Question: My 2 year old daughter was just diagnosed with mono (positive ebv). Initially, they were suspecting leukemia. After the test results were back and said she had mono, they are wanting blood work....cbc. Just curious if her labs reflect ebv or should I be concerned there is something else going on? She had labs drawn on a Thursday and the following Monday. Results are as follows:

Thursday. Monday
WBC 10.6 WBC 15.7 (H)
Hemoglobin 9.9 (L). Hemoglobin 10.8 (L)
Mean corp hgb 30.7 (L). Hematocrit 31.1 (L)
Manual neutrophils 13.0 (L). Manual neutrophils 12.0 (L)
Manual REACT lymphocytes 16.0 (H). Manual lymphocytes 87 (H)
Manual absolute lymphocytes 6.36 Manual absolute lymphocytes 13.66
Smudge cells 52 (H). Sed rate 31 (H)
Also, I just received the following lab results:

EBV AB VCA, IgM- 160.0 (H)
EBV early antigen AB, IgG- 64.3 (H)
EBV viral capsule antigen, IgG- 70.7 (H)
EBV nuclear antigen AB, IgG- <18

EBV interpretation showed the following as positive:
Early phase (EBV-IgM)
Acute primary (EBV-IgM and VCA-IgG)
Convalescence/past (VCA-IgG,EBNA-IgG)
Reactivated (VCA-IgG, EBNA-IgG, EA (D)-IgG)

Following results showed (+ or -):
Acute primary (EA(D)-IgG)
Convalescence/past (EA(D)-IgG)
Reactivated (EBV-IgM)

I know she does have mono but just wanting to know if her labs look suspicious enough to warrant further testing for other possible diagnosis.
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Answered by Dr. Prashant Sharma 2 days later
Brief Answer:
No chances of leukemia

Detailed Answer:
Hi madam,

Many times it is difficult to differentiate between mono and leukemia based on the symptoms alone. So we order tests.

In leukemia peripheral blood film shows blasts along with other lymphocytes, which are not seen in your daughter's case so doctors ruled out that.

In addition reports clearly indicate it to be an infection by EBV, so there should be no doubt now. The treatment for mono depends on the condition of patient, symptoms and the nutritional status of child. The pediatrician looking after her will decide about the treatment. Follow his/her advise. She will be alright soon.

Feel free to ask further.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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