When EBV serology needs a blot to reach a conclusion: A case report
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81
A 14-year-old patient underwent a liver transplant. Three months after transplantation, EBV-associated lymphoma was suspected. EBV serologies before and after transplantation were particularly discrepant. Eighteen months before transplantation, the serological profile suggested a recent EBV primary infection; four months before transplantation, we had isolated anti-EBNA IgG; and five days after transplantation, the serological profile suggested a past infection. All EBV PCRs performed on whole blood were negative. Retrospectively, anti-EBV IgG immunoblots were performed. The blots showed no anti-EBV IgG before and until the day of liver transplantation. Five days after transplantation, slight bands of both IgG anti-p18 (VCA) and anti-EBNA-1 were found, without any other serological marker. These were probably due to passive transfers of IgG during surgery. There was therefore no argument for immunization against EBV before or after liver transplant for this patient.
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