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memory for pool. in /usr/local/www/apache22/data/sapphire/dev/Log.php on line 2 Warning: include_once(): Unable to allocate memory for pool. in /usr/local/www/apache22/data/sapphire/core/Core.php on line 70 Warning: require_once(): Unable to allocate memory for pool. in /usr/local/www/apache22/data/sapphire/thirdparty/Zend/Log.php on line 124 Warning: require_once(): Unable to allocate memory for pool. in /usr/local/www/apache22/data/sapphire/thirdparty/Zend/Log/Exception.php on line 23 EBV Antikorları: Test

Epstein-Barr Virüsü Antikorları

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Diğer Adları: EBV Antikorları ; EBV VCA-IgM Ab; EBV VCA-IgG Ab; EBNA-IgG Ab; EA-D IgG Ab
Resmi adı: Viral Kapsül Antijenine karşı oluşan Epstein-Barr Virüs Antikoru;, IgG; Nükleer antijene karşı oluşan Epstein-Barr Virus Antikoru, IgG; Erken Evre D Antijenine karşı oluşan Epstein-Barr Virüs Antikoru, IgG; Heterofil Antikorlar (bkz Mono)

Bir Bakışta

Niçin Testi Yaptıracaksınız?

Mononükleoz (Mono); tanısı koymaya, EBV enfeksiyonuna yatkınlığı değerlendirmeye, EBV enfeksiyonuyla benzer hastalık belirtileri olan başka bir rahatsızlığı değerlendirmeye yardımcı olmak için bu test yapılır.

Ne Zaman Testi Yaptıracaksınız?

Mononükleoz bulgularınız olmasına rağmen mononükleoz testiniz negatifse, gebe kadında soğuk algınlığına benzer yakınmalar mevcutsa, bazen asemptomatik bir kişi mononükleoza maruz kalmışsa EBV testi yapılır.

Gerekli Numune Nedir?

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Test için Hazırlık Gerekir mi?

Test için hazırlık yapılması gerekmemektedir.

Test Numunesi

Ne test edilmektedir?

Epstein-Barr virus (EBV) antikor testleri, yakın zamanlı veya eski EBV enfeksiyonu tanısı koymaya yardımcı olmak için istenen testler grubudur. EBV, herpes (uçuk) virüsü ailesindendir. Tükrükle geçen virüs çok sık görülen bir enfeksiyona neden olmaktadır. Virüse maruziyetten sonra birkaç haftalık bir kuluçka dönemi mevcuttur. EBV daha sonra bir akut primer enfeksiyon, ardından enfeksiyonun geçtiği ve "uyuduğu"  latent dönemlerin oluşmasına neden olur. Latent EBV yaşamının geri kalan bölümünde gizli kalır, ara ara yeniden aktif hale geçmesine rağmen hastanın bağışıklık sistemi önemli oranda risk altında değilse az sayıda soruna neden olur.

Çocukların çoğu EBV ile enfekte olmalarına rağmen enfeksiyonun şiddetli olduğu zamanlarda bile az sayıda (veya hiç) hastalık belirtisi göstermektedir. Ancak, başlangıçtaki enfeksiyon ergenliğe kadar geciktirildiğinde enfekte olanların yaklaşık % 35-50'sinde  EBV, enfeksiyöz mononükleoza neden olmaktadır. Mononükleoz yorgunluk, ateş, boğaz yangısı, lenf (akkan) düğümleri şişliği dalak ve bazen karaciğer büyümesiyle ilişkilendirilen bir hastalıktır. Bu hastalığa yakalanmış olanlar ilk enfeksiyon iyileşmeden bir veya 2 ay öncesine kadar  genellikle hastalık belirtileri göstermektedir.

Mononükleoz tanısı hastalık bulguları, tam kan sayımı (TKS) ve mononükleoz testiyle (heterofil antikor testi) ile tanı konur. Mononükleoz hastalarının belli bir yüzdesinde, özellikle çocuklarda geçerli olmak üzere mononükleoz testi negatif çıkacaktır.  Bu  hastaların yakınmalarının halen geçirdikleri EBV virüs enfeksiyonuna bağlı olup olmadığını belirlemek için EBV antikorlarından yararlanılabilir.

EBV'yi diğer hastalıklardan ayırt etmek önemli olabilir. Örneğin mononükleoz hastalarının büyümüş dalakları yırtılmaya karşı dayanıksızdır. Mononükleoz hastaları dalak yırtılması tıbben acil bir duruma yol açabildiğinden enfeksiyon geçtikten sonra haftalar veya aylar içinde temas sporlarıyla uğraşmamalıdır. Bir viral hastalık belirtileri olan gebe kadınlarda, bebeği olumsuz etkilediği gösterilmemiş olan birincil EBV enfeksiyonuyla gebelik sırasında komplikasyonlara neden olabilen ve fetüse (cenine) zarar verebilen sitomegalovirüs (CMV), herpes simpleks virüsü, veya toksoplazmoz enfeksiyonu birbirlerinden ayırt edilebilmelidir. EBV'nin ekarte edilmesi ve hastalık belirtileri için başka nedenlerin araştırılması da önemli olabilir. Örneğin, streptokoksik boğaz enfeksiyonu olan hastaların belirlenmesi ve antibiyotiklerle tedavi edilmesi gerekir. Hastada mononükleoz yerine streptokoksik boğaz enfeksiyonu veya aynı zamanda her ikisi birden mevcut olabilir.

Birkaç çeşit EBV antikoru mevcuttur. Bu antikorlar birkaç farklı Epstein-Barr virüsü antijenine karşı oluşan bağışıklama yanıtı olarak vücut tarafından oluşturulan proteinlerdir. Viral kapsit antijenine (VCA) karşı IgM ve IgG antikorlarını, erken evre D antijenine (EA-D) karşı IgG antikorlarını ve hücre çekirdeği antijenine (EBNA) karşı oluşan  antikorları oluşturur. Bir birincil EBV enfeksiyonu sırasında bu EBV antikorlarının her biri kendi başlarına bağımsız olarak kendi zaman takvimlerine göre ortaya çıkarlar. İlkin  VCA-IgM antikoru ortaya çıkar, 4-6 hafta sonra kaybolma eğilimi gösterirler. VCA-IgG antikoru en yüksek düzeyine 2-4. haftalarda ulaşır, daha sonra yavaşça azalır ve yaşam boyu sabit düzeylerde kalır . EA-D antikoru bir akut enfeksiyon dönemi sırasında ortaya çıkar ve daha sonra 3-6 ay içinde kaybolmaya başlamasına karşın EBV enfeksiyonu geçtikten birkaç yıl sonrasına kadar enfeksiyon kapmış olanların yaklaşık % 20 kadarında EA-D antikorları ölçümlenebilir düzeylerde olmayı sürdürecektir. EBNA antikoru genellikle akut enfeksiyon geçmeden kaybolmaz. İlk enfeksiyon ortaya çıktıktan yaklaşık 2-4 ay sonra gelişimini tamamlamakta ve yaşam boyu sebat etmektedir.  Bu EBV antikor testlerinin kombinasyonunu kullanarak doktor, EBV enfeksiyonunu saptayabilir, eski, yakın zamanlı veya halen geçirilmekte olan bir enfeksiyonun varlığını belirleyebilir.

Test için numune nasıl toplanır?

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Numunenin kalitesinden emin olmak için herhangi bir test hazırlığına gerek var mı?

Test için hazırlık yapılması gerekmemektedir

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Makalenin Kaynakları

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NOT: Bu makale, burada söz edilen kaynaklarla birlikte Lab Tests Online Editörler İnceleme Kurulunun toplu deneyiminden yararlanan araştırmaya dayanmaktadır. Bu makale belli aralıklarla Editörler Kurulu tarafından gözden geçirilmekte ve inceleme sonuçlarına göre güncelleştirilebilmektedir. Alıntı yapılan her yeni kaynak listeye eklenecek ve kullanılan orijinal kaynaklardan ayırt edilecektir.

En son gözden geçirmede kullanılan kaynaklar

Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby’s Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 401-403.

Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp 1556-1557.

Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition]. Pp 663.

Smith, D. S. (2007 August 6). Epstein-Barr virus test. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003513.htm. Accessed on 11/23/08.

Bennett, N. J. and Domachowske, J (2008 August 12). Mononucleosis and Epstein-Barr Virus Infection. EMedicine [On-line information]. Available online at http://www.emedicine.com/ped/TOPIC705.HTM through http://www.emedicine.com. Accessed on 11/23/08.

(© 2006-2008). Epstein-Barr Virus – EBV. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/InfectiousDz/Viruses/EBV.html through http://www.arupconsult.com. Accessed on 11/23/08.

Mayo Clinic Staff (2008 June 28). Mononucleosis. MayoClinic [On-line information]. Available online at http://www.mayoclinic.com/health/mononucleosis/DS00352 through http://www.mayoclinic.com. Accessed on 11/23/08.

(2005 November). Infectious Mononucleosis. The Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec14/ch189/ch189f.html?qt=EBV&alt=sh through http://www.merck.com. Accessed on 11/23/08.

Peridin F, et. al (Published online 2007 March 28). Comparison of commercial and in-house Real-time PCR assays for quantification of Epstein-Barr virus (EBV) DNA in plasma. BMC Microbiol. 2007; 7: 22. Available online at http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=pmc1852802 through http://www.pubmedcentral.nih.gov. Accessed January 2009.

(Updated Feb 2, 2009) Centers for Disease Control and Prevention. Epstein-Barr Virus and Infectious Mononucleosis. Available online at http://www.cdc.gov/ncidod/diseases/ebv.htm through http://www.cdc.gov. Accessed February 2009.

Daha önceki gözden geçirmede kullanılan kaynaklar

Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO. Pp 373-375.

Ebell, M. (2004 October 1). Epstein-Barr Virus Infectious Mononucleosis. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/20041001/1279.html through http://www.aafp.org.

Levy, D. (2004 January 19, Updated). Epstein-Barr virus test. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003513.htm.

(© 1995-2005). Epstein-Barr Virus Infection. The Merck Manual- Second Home Edition [On-line information]. Available online at http://www.merck.com/mmhe/sec17/ch198/ch198f.html through http://www.merck.com.

(© 2005). Epstein-Barr Virus. ARUP’s Guide to Clinical Laboratory Testing [On-line information]. Available online at http://www.aruplab.com/guides/clt/tests/clt_a238.jsp#1147825 through http://www.aruplab.com.

Schmid, S., Leader Herpesvirus Group (2005 September 13, Updated). Epstein-Barr Virus and Infectious Mononucleosis. CDC, National Center for Infectious Diseases [On-line information]. Available online at http://www.cdc.gov/ncidod/diseases/ebv.htm through http://www.cdc.gov.