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Old 07-29-2008, 08:52 AM   #1
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Ebv

Hello All

Could anyone knowledgable on EBV please advise me on the following results ?

EBNA IgG antibody Positive 600.0 U/ml....(Normal < 5 U/ml)
EBV Early Ag ab.(IgG) Positive 50.8 U/ml....(Normal < 10 U/ml)
EBV Early Ag ab.(IgM) Negative 10.0 U/ml....(Normal < 20 U/ml)

From what I understand the above means at one time I was infected with the Epstein Barr Virus, but could this still be affecting me, as I dont feel good at al, my symptoms are

Pain in the liver area ( for the last 3-4 years ) I have had 3 blood tests since Jan, the first was okay, second showed higher than normal ALT was 3 times the norm and AST was a little over twice the normal, my creatine kinase was 22 times normal level, liver test done the next week was normal ALT/AST 26 & 26, so it was put down to the fact that I had been training hard in the gym and had hurt my arm. The latest blood test showed LDH @ 535 and Triglycerides 3.4 ( fasted sample ) but all else normal. The pain is sometimes sharp and feels like its just under my sternum or other times further over my ribs,

Sinuses/ nostril sometimes feel like they are burning, as does lower legs and skin over the right ribs ( All Hep ABC negative ( C by Antibody and PCR neg )

General malaise and cant be bothered

Sometimes a dizzy feeling in my head, can concentrate very well, have problems remembering stuff

Occasional blood blisters in my mouth

Night sweats, at least 3 times a week

Extreme anxiety, more like anxiety trips, seems to last 5-6 days then it dissapears, it feels like all the muscles in my head relax and the anxiety goes, really weird.

Lots of muscle twitching, sometimes more like the muscle spasaming all over

Guys I would really appreciate if some one can help me with this, I havent been feeling good for sometime now and I need to get closure or treatment, yes ! anxiety and stress are contributing factors but there is without doubt something not right with me and it is taking over my life !

Would really appreciate your help and advice !

Regards

Worriedtobits

 
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Old 07-29-2008, 01:15 PM   #2
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Re: Ebv

Hi there,

So according to your EBV results, yes, what it's saying is you were exposed at some time (which many people in the population are) and it doesn't mean much UNLESS you were going to need a transplant later (which I'm guessing you don't).

Your symptoms are all very non-specific, and are likely unrelated. I am NOT by ANY means saying you're crazy or that "it's all in your head", but they are unlikely related to any underlying infection.

As for your liver enzymes being elevated above normal--that is interesting. It is hard for that to be something that is just a fluke (no pun intended).

The CK being elevated may have to do with your training hard, and in fact, while one's liver enzymes can go up with hepatitis, they can also go up quite substantially with muscle damage as well. Usually it is the AST which can go up with the CK indicated muscle damage (say from heavy training), but the ALT can go up as well.

Now that they're back to normal, there's a couple of things that should be done:

First off, how old are you, and do you have any other previous health problems?

Where were you born? Is there anyone in your family who has had any liver diseases, including Hepatitis B or C?

Have you ever been jaundiced?

Are you on any medications including over-the-counters or herbals?

Because your liver enzymes were up at a certain point, depending on how old you are and the answers to the above questions, you should have a quick blood test screen for other chronic liver diseases:

Hepatitis A/B/C
Wilson's Disease (if you're a young man)
Hemachromatosis
Alpha-1 Antitrypsin Deficiency
Autoimmune Hepatitis (if you're a young woman)

You should probably also get an abdominal ultrasound. These are just a few things which can be done to rule out underlying liver disease.

Disclaimer: These are suggestions based on what you've told me. If you've been to the doctor and s/he's taken a different approach, go by what s/he says. Your doctor has a much more complete story than I do and should be trusted with your clinical course.

 
Old 07-29-2008, 04:24 PM   #3
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Re: Ebv

Thanks for taking the rime to reply to my post !

Im M/35 and otherwise pretty healthy, I do smoke bout 20 a day !, born in the Uk, no known liver problems in the family, cancer is the biggy in my lot !

I have had an abdominal ultrasound done but no problems were noted !

Been tested for Hep ABC, I was immunised for Hep A in Feb so that showed positive for that or past infection, B negative, C I was tested for by both Antibody and PCR, both negative. Neg for all STD's ( Blood/culture/urine)

Havent been tested for all the others, might be an idea, but wouldnt my LFT's be severely raised in Auto immune and rings round my eyes in Wilsons ? Iron levels are normal ( phosphate levels always appear to be very slightly low), lung capacity is good !

I do appear to be having problems with my sinuses, my nostril sometimes feel like they are burning and my breathing feels slightly restricted but im not congested ( this didnt cure when I gave up smoking), got a wee bit of tinitus.
in my left ear sometimes too. In Feb I my sinuses really felt weird, like the were being pulled inside, felt rushes also, like they were travellin into my brain, and my nose went completely numb for a week, lost all feeling, my sinuses did swell at that time, strangely enuff I looked good coz the swelling got rid of the bags under my eyes.

I wasnt taking any over the counter Vits while these tests were being done but am now taking Vit C,B and Echinacea.

No ! never been jaundiced, but the capilliarys in both my eyes do appear rather prominent,

Doctor just says anxiety, and yes I am anxious and when i sit down and talk to doctors I feel more anxious because im dreading what they are going to find, but mainly because I know something isnt right, this all started after unprotected sex with a woman, im positive thats when i got the EBV coz my throat did really hurt alot for a whileas did my nodes in my neck, but at that time ( 4 years ago ) I didnt think much of it, during that time I would also vomit alot, mostly after Tea/ Coffee / soup................liquids in general, also in that period I would itch like crazy on my legs and back of the neck, would leave welts where I had scratched. Had a nasty bout of oral thrush and stomach acid then also.


All a wee bit jumbled together I know, but you advice would be very much appreciated.

gain, thank you for taking the time

Worriedtobits




Quote:
Originally Posted by cgranulomatis View Post
Hi there,

So according to your EBV results, yes, what it's saying is you were exposed at some time (which many people in the population are) and it doesn't mean much UNLESS you were going to need a transplant later (which I'm guessing you don't).

Your symptoms are all very non-specific, and are likely unrelated. I am NOT by ANY means saying you're crazy or that "it's all in your head", but they are unlikely related to any underlying infection.

As for your liver enzymes being elevated above normal--that is interesting. It is hard for that to be something that is just a fluke (no pun intended).

The CK being elevated may have to do with your training hard, and in fact, while one's liver enzymes can go up with hepatitis, they can also go up quite substantially with muscle damage as well. Usually it is the AST which can go up with the CK indicated muscle damage (say from heavy training), but the ALT can go up as well.

Now that they're back to normal, there's a couple of things that should be done:

First off, how old are you, and do you have any other previous health problems?

Where were you born? Is there anyone in your family who has had any liver diseases, including Hepatitis B or C?

Have you ever been jaundiced?

Are you on any medications including over-the-counters or herbals?

Because your liver enzymes were up at a certain point, depending on how old you are and the answers to the above questions, you should have a quick blood test screen for other chronic liver diseases:

Hepatitis A/B/C
Wilson's Disease (if you're a young man)
Hemachromatosis
Alpha-1 Antitrypsin Deficiency
Autoimmune Hepatitis (if you're a young woman)

You should probably also get an abdominal ultrasound. These are just a few things which can be done to rule out underlying liver disease.

Disclaimer: These are suggestions based on what you've told me. If you've been to the doctor and s/he's taken a different approach, go by what s/he says. Your doctor has a much more complete story than I do and should be trusted with your clinical course.

 
Old 07-29-2008, 09:31 PM   #4
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Re: Ebv

Quote:
Originally Posted by Worriedtobits View Post
Thanks for taking the rime to reply to my post !

Im M/35 and otherwise pretty healthy, I do smoke bout 20 a day !, born in the Uk, no known liver problems in the family, cancer is the biggy in my lot !

I have had an abdominal ultrasound done but no problems were noted !

Been tested for Hep ABC, I was immunised for Hep A in Feb so that showed positive for that or past infection, B negative, C I was tested for by both Antibody and PCR, both negative. Neg for all STD's ( Blood/culture/urine)

Havent been tested for all the others, might be an idea, but wouldnt my LFT's be severely raised in Auto immune and rings round my eyes in Wilsons ? Iron levels are normal ( phosphate levels always appear to be very slightly low), lung capacity is good !

I do appear to be having problems with my sinuses, my nostril sometimes feel like they are burning and my breathing feels slightly restricted but im not congested ( this didnt cure when I gave up smoking), got a wee bit of tinitus.
in my left ear sometimes too. In Feb I my sinuses really felt weird, like the were being pulled inside, felt rushes also, like they were travellin into my brain, and my nose went completely numb for a week, lost all feeling, my sinuses did swell at that time, strangely enuff I looked good coz the swelling got rid of the bags under my eyes.

I wasnt taking any over the counter Vits while these tests were being done but am now taking Vit C,B and Echinacea.

No ! never been jaundiced, but the capilliarys in both my eyes do appear rather prominent,

Doctor just says anxiety, and yes I am anxious and when i sit down and talk to doctors I feel more anxious because im dreading what they are going to find, but mainly because I know something isnt right, this all started after unprotected sex with a woman, im positive thats when i got the EBV coz my throat did really hurt alot for a whileas did my nodes in my neck, but at that time ( 4 years ago ) I didnt think much of it, during that time I would also vomit alot, mostly after Tea/ Coffee / soup................liquids in general, also in that period I would itch like crazy on my legs and back of the neck, would leave welts where I had scratched. Had a nasty bout of oral thrush and stomach acid then also.


All a wee bit jumbled together I know, but you advice would be very much appreciated.

gain, thank you for taking the time

Worriedtobits
Hi worriedtobits,

With all due respect, I can tell just by your posts that you are a very nervous person, and additionally, you have become very hypervigilant of your own body and symptoms. The fact that you've noticed the capillaries in your eyes is illustrative of this. Again, I am NOT saying you're crazy or that this is all in your head--I am just saying that your anxiety is playing a significant role in making you feel the way you do.

The other thing I wonder is that if this is all rooted in the sexual contact you mentioned. Are you nervous about something you may have caught from that contact other than just EBV?

You mention the doctors make you nervous because you "dread what they might find". What exactly are you afraid of? It might help to identify what that actually is.

In response to the other stuff you mentioned:

Your liver enzymes may chronically be high with autoimmune hepatitis, but they may also not be. You're right about having rings around your irises in Wilson's disease. They're called Keyser-Fleischer rings, but they an only really be seen with a special slit lamp unless they're really bad. Unfortunately, a lot of liver disease is totally asymptomatic which is why they do all those screening tests (though I have a feeling that was already done for you).

I want to stress again to you that I am NOT ridiculing you when I speak of your anxiety and hypervigilance being a significant component of your problem. Many people who have a background of anxiety often respond after an acute health problem by becoming very hypervigilant of their symptoms. It's a bit of a vicious cycle because the more hypervigilant you become the more you notice things that you didn't notice before, but are actually normal. This makes one more anxious and they become MORE hypervigilant and so on. Interestingly, many people who have the problem of hypervigilance tend to be educated, intelligent people who are very self-aware! So, in a way, it's the eye of the person's intelligence being turned upon himself! Does that make sense?

In any case, if your liver enzymes have come back to normal and you're feeling fine, you likely don't have anything serious. Acute EBV infection can cause a mild, temporary hepatitis which resolves on its own. Being exposed to EBV is VERY VERY common, and most people are simply asymptomatic.

 
Old 07-30-2008, 12:56 AM   #5
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Re: Ebv

Hi again

I fully understand what you are saying about the hyper vigilance, any noise my body makes or any abnormality with my partner toally freaks me out and begins one of my "anxiety trips".

But ! it is very hard to beleive that this pain in my ribs/liver area is just in my imagination, because sometimes is really does hurt and the problems with my sinuses feels very real ( did I mention I get penile thrush quite often also )

Oh and wow ! you hit the nail on the head with, the intelligent thing, I do a job which requires a high degree of skill and supposedly alot of intelligence, I havent been working for about 4 months, which has turned my supposed intelligence to my body and reading the net !!!!!!!!!!!!!!!!!!!

What I really worry about most is that I may have caught something that I may have passed onto my partner !, but I have been tested for every STD going and all has came back negative ! but i still worry due to the liver area pain and all the other symptoms I have !

Thanks again for the advice

WTB

Last edited by Worriedtobits; 07-30-2008 at 02:58 AM.

 
Old 07-30-2008, 08:28 AM   #6
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Re: Ebv

Quote:
Originally Posted by Worriedtobits View Post
Hi again

I fully understand what you are saying about the hyper vigilance, any noise my body makes or any abnormality with my partner toally freaks me out and begins one of my "anxiety trips".

But ! it is very hard to beleive that this pain in my ribs/liver area is just in my imagination, because sometimes is really does hurt and the problems with my sinuses feels very real ( did I mention I get penile thrush quite often also )

Oh and wow ! you hit the nail on the head with, the intelligent thing, I do a job which requires a high degree of skill and supposedly alot of intelligence, I havent been working for about 4 months, which has turned my supposed intelligence to my body and reading the net !!!!!!!!!!!!!!!!!!!

What I really worry about most is that I may have caught something that I may have passed onto my partner !, but I have been tested for every STD going and all has came back negative ! but i still worry due to the liver area pain and all the other symptoms I have !

Thanks again for the advice

WTB
Haha..yeah, the internet can be a very scary place to gain knowledge--especially medical knowledge. Why? It's because people who don't have medical training are getting knowledge that is not context-specific. Additionally, you can't GET that context unless you've done clinical medicine.

So let's look at your "liver pain" objectively. What are the serious things it could be? Well, first of all hepatitis. Do you have hepatitis? Well, you might have had a transient hepatitis in the past, but it's gone. The scary things (i.e. hepatitis B and C) have been ruled out. Also, for hepatitis to give you PAIN, the liver has to swell so that it's stretching its capsule. In that case, your liver enzymes would STILL be elevated. Additionally, you'd likely see something on ultrasound, which we know in you was normal.

The next thing: gallstones, could you be having gall bladder attacks? Sure, but the ultrasound ruled out anything immediately dangerous. So that's not likely it.

What about other weird infections? Well, you seem to be very worried about something sexually transmitted. Well, hepatitis B is sexually transmitted, but that's been ruled out. Second, gonorrhea can cause inflammation of the pelvic organs and then spread to the liver causing inflammation of it in a syndrome called Fitz-Hugh-Curtis.....IN WOMEN! You're obviously not a woman! Other things you're worried about I bet you include HIV, which doesn't cause hepatitis.

What about alcohol? Sure, that can cause hepatitis, but your liver enzymes would be up in a pattern different from what you're telling me, and generally it is a very acute presentation which occurs about 6 weeks after a sustained drinking binge, and you get really sick and jaundiced (which didn't happen to you).

Oh, and the last thing people are always anxious about is liver cancer. Well, liver cancer almost always presents in people who have cirrhotic livers, which you likely do not have because your ultrasound is normal (there are other markers of cirrhosis..I'm just keeping things simple). The second way to get liver cancer in N. America or Europe is if you are a carrier of Hepatitis B, which we know you are not.

So that begs the question: then what is this pain you're having? Well, because pain in your right upper quadrant is MUCH more likely to come from muscle strains, that's probably what it is. We also know that you train very hard, so a muscle pull is not out of the question. I can guarantee you that, if you have a muscle pull in your right upper quadrant, that you are much more aware of it because you know your liver is there.

I know my objective explanation won't totally get rid of your anxiety, but I hope I have at least outlined how unlikely you have what you are afraid of.

 
Old 08-27-2008, 10:28 AM   #7
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Re: Ebv

WTB..
Sorry about you being worried.. but your mail was amusing (somehow good job at maintaing some sense of humor while you'r egoing through crap)
Just wanted to chime in and say there are others that share the sentiments you have for the supposedly "skill requiring" jobs .. HA!!

 
Old 08-27-2008, 10:32 AM   #8
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dream77 HB User
Re: Ebv

cgran..
your analytical approach is awesome..
I wish the docs I used to see did not pretend patients were dumb enough to not understand and would go over their thought process chronologically and methodically

 
Old 08-27-2008, 08:03 PM   #9
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Re: Ebv

Thanks dream!

I guess one problem doctors face is that there is not a lot of time to explain things. But yeah, you're totally right, no doctor should assume his/her patient won't understand what's going on if explained in layman's terms.

 
Old 07-22-2011, 05:06 PM   #10
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Re: Ebv

Quote:
Originally Posted by Worriedtobits View Post
Hello All

Could anyone knowledgable on EBV please advise me on the following results ?

EBNA IgG antibody Positive 600.0 U/ml....(Normal < 5 U/ml)
EBV Early Ag ab.(IgG) Positive 50.8 U/ml....(Normal < 10 U/ml)
EBV Early Ag ab.(IgM) Negative 10.0 U/ml....(Normal < 20 U/ml)

From what I understand the above means at one time I was infected with the Epstein Barr Virus, but could this still be affecting me, as I dont feel good at al, my symptoms are

Pain in the liver area ( for the last 3-4 years ) I have had 3 blood tests since Jan, the first was okay, second showed higher than normal ALT was 3 times the norm and AST was a little over twice the normal, my creatine kinase was 22 times normal level, liver test done the next week was normal ALT/AST 26 & 26, so it was put down to the fact that I had been training hard in the gym and had hurt my arm. The latest blood test showed LDH @ 535 and Triglycerides 3.4 ( fasted sample ) but all else normal. The pain is sometimes sharp and feels like its just under my sternum or other times further over my ribs,

Sinuses/ nostril sometimes feel like they are burning, as does lower legs and skin over the right ribs ( All Hep ABC negative ( C by Antibody and PCR neg )

General malaise and cant be bothered

Sometimes a dizzy feeling in my head, can concentrate very well, have problems remembering stuff

Occasional blood blisters in my mouth

Night sweats, at least 3 times a week

Extreme anxiety, more like anxiety trips, seems to last 5-6 days then it dissapears, it feels like all the muscles in my head relax and the anxiety goes, really weird.

Lots of muscle twitching, sometimes more like the muscle spasaming all over

Guys I would really appreciate if some one can help me with this, I havent been feeling good for sometime now and I need to get closure or treatment, yes ! anxiety and stress are contributing factors but there is without doubt something not right with me and it is taking over my life !

Would really appreciate your help and advice !

Regards

Worriedtobits

 
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