EBV IgM antibody to Nuclear antigen (NA)

Bacterial/ Viral

Report in 120Hrs

At Home

No Fasting Required

Details

Detects Epstein-Barr virus antibodies.

₹2,264₹3,235

30% OFF

EBV IgM Antibody to Nuclear Antigen (NA) - Comprehensive Medical Test Guide

Why is it done?
- Test Purpose: Detects IgM antibodies against Epstein-Barr virus (EBV) nuclear antigens to identify acute or recent EBV infection
- Primary Indications: Suspected acute EBV infection; infectious mononucleosis diagnosis; evaluation of fever of unknown origin; assessment of patients with clinical symptoms suggestive of EBV infection
- Clinical Symptoms Prompting Test: Fever, sore throat, severe fatigue, swollen lymph nodes, headache, muscle aches, elevated liver enzymes, or atypical lymphocytes on blood smear
- Typical Timing: Ordered during acute phase of illness (typically first 2-4 weeks of symptom onset); IgM levels peak at the onset of clinical symptoms and decline within 3-6 months
- Distinction from Other Antigens: EBV-NA (nuclear antigen) differs from viral capsid antigen (VCA) and early antigen (EA) testing; NA IgM is specific for acute EBV infection
Normal Range
- Normal Result: Negative or < 0.10 Index (or < 1:10 titer, depending on laboratory); indicates absence of acute EBV infection
- Units of Measurement: Index values (0.0-1.0 scale), antibody titer ratios (1:10, 1:20, 1:40, etc.), or optical density (OD) measurements; specific units vary by laboratory methodology (ELISA, immunofluorescence, or chemiluminescence)
- Positive Result: > 0.10 Index (or ≥ 1:10 titer); indicates recent or acute EBV infection
- Borderline/Equivocal Results: Index values 0.08-0.12 may require repeat testing or additional serological markers (VCA-IgG, VCA-IgM) for definitive interpretation; clinical correlation essential
- Interpretation Summary: Positive IgM-NA indicates acute infection; negative result excludes acute EBV infection but does not exclude past infection or chronic/reactivated disease
Interpretation
- Positive IgM-NA Result: Strongly suggests acute EBV infection (primary infection or rarely reactivation); clinically compatible with infectious mononucleosis diagnosis; indicates current active viral replication
- Negative IgM-NA Result: Excludes acute EBV infection; consistent with past infection (immunity), negative serology, or if symptoms are present but test negative, may indicate non-EBV etiology of illness
- Temporal Pattern of Results: IgM appears early in infection (prodromal phase), peaks with clinical symptoms, then declines; absence of IgM after 3-6 months indicates acute phase has resolved; presence beyond 6 months suggests ongoing or persistent infection
- Combination with Other Markers: IgM-NA+ with VCA-IgG+ and EA+ = acute infection; IgM-NA+ with VCA-IgG- = very early acute infection; IgM-NA- with VCA-IgG+ = past infection or chronic infection
- Factors Affecting Results: Timing of test relative to infection onset; immunocompromise (may have blunted or absent IgM response); prior EBV exposure; presence of heterophile antibodies; laboratory methodology variations; pregnancy may affect antibody responses
- Clinical Significance of Different Patterns: High IgM titers indicate recent primary infection; very high titers may correlate with severity of symptoms; persistence of IgM may indicate complicated infection or immunological abnormality
- False Positive Considerations: Rare but possible with certain laboratory methods; autoimmune diseases, other infections (CMV, HHV6), and cross-reactivity may cause false positives; clinical correlation and confirmatory testing recommended
- False Negative Considerations: Possible if tested very early before IgM response (first few days); in severe immunosuppression (HIV, post-transplant); late in acute phase; pregnancy may reduce IgM responses
Associated Organs
- Primary Organ Systems Involved: Lymphoid system (lymph nodes, spleen, tonsils); immune system (B lymphocytes primarily affected); can involve multiple organ systems including liver, heart, nervous system, respiratory tract
- Diseases and Conditions Diagnosed: Infectious mononucleosis (IM); acute EBV infection in immunocompromised patients; primary EBV infection complications
- Common Associated Complications: Hepatitis (elevated transaminases); splenomegaly (splenic rupture risk); airway obstruction from pharyngeal edema; myocarditis or pericarditis; meningitis/encephalitis; peripheral neuropathy; secondary bacterial superinfection of throat
- Liver (Hepatic) Involvement: EBV commonly causes hepatitis; elevated liver enzymes (ALT, AST) occur in majority of acute infections; rarely progresses to fulminant hepatic failure
- Spleen Involvement: Splenomegaly occurs in 50% of acute infections; risk of rupture from minor trauma; requires activity restriction during acute phase
- Hematologic Complications: Atypical lymphocytosis; thrombocytopenia (rarely severe); hemolytic anemia (autoimmune); coagulopathy in severe cases
- Neurologic Complications: Aseptic meningitis; encephalitis; Guillain-Barré syndrome; Bell's palsy; transverse myelitis; rare but serious
- Cardiac Involvement: Myocarditis or pericarditis; arrhythmias; cardiomegaly; typically self-limited but requires monitoring
- Respiratory Tract: Pharyngitis; tonsillitis; airway obstruction; laryngeal edema; pneumonitis; these may require hospitalization if severe
Follow-up Tests
- Confirmatory Serology Tests: EBV VCA-IgG (Viral Capsid Antigen); EBV VCA-IgM; EBV Early Antigen (EA); EBV-NA IgG; helps establish timing and completeness of immune response
- Heterophile Antibody Test (Monospot): Quick screening test; positive supports EBV diagnosis; may be negative early in infection or in children <4 years
- Complete Blood Count (CBC): Evaluates for atypical lymphocytes, lymphocytosis, thrombocytopenia; supports diagnosis; monitors for hematologic complications
- Liver Function Tests (LFTs): AST, ALT, bilirubin, albumin; recommended to assess hepatic involvement; usually normalize within 3-6 months
- Throat Culture/Rapid Strep Test: Rule out bacterial superinfection (Group A Streptococcus); if positive, may need antibiotics; negative helps confirm viral etiology
- Imaging Studies (if complications suspected): Abdominal ultrasound for splenic size/rupture risk; chest X-ray for pneumonitis; CT/MRI brain if neurologic symptoms present
- EBV DNA PCR (Quantitative): For immunocompromised patients or persistent/reactivated infection; monitors viral load; guides antiviral therapy
- Repeat Serology (if initial result equivocal): Test repeated after 1-2 weeks if borderline; rising IgM titers confirm acute infection; static or declining titers suggest past infection
- Monitoring Frequency: Uncomplicated acute infection: clinical monitoring; complications require closer follow-up (weekly-biweekly); repeat LFTs at 4-6 weeks; immunocompromised patients need more frequent EBV DNA monitoring
- Test to Rule Out Other Causes: CMV serology; HHV-6 testing; HIV testing; Toxoplasma serology; Leptospira serology; depending on clinical presentation and epidemiology
Fasting Required?
- Fasting Required: NO
- Specimen Collection: Requires serum blood sample; can be collected at any time of day; no special fasting requirements; collection tube typically SST (serum separator tube) or plain tube
- Medications to Avoid: No specific medications must be withheld; however, immunosuppressive drugs (corticosteroids, immunoglobulin therapy) may affect antibody response and should be noted on test requisition
- Patient Preparation: Can eat and drink normally before blood draw; no fasting period required; regular activities may be continued; arrive hydrated for easier venipuncture
- Special Instructions: Inform laboratory of immunocompromise status, recent blood transfusion, or recent immunoglobulin administration; note current symptoms and date of symptom onset on requisition for proper result interpretation; timing of test relative to symptom onset is crucial
- Sample Handling: Blood should be processed within 24 hours; serum separated and refrigerated if processing delayed; transport according to laboratory standards
- Optimal Testing Window: Most accurate during first 2-4 weeks of symptom onset; earlier than 1 week may give false negative; after 3-6 months, IgM may be undetectable even in confirmed infection

How our test process works!