Here is My Question:
Does an MS neurologist need to know if his/her patient has mononucleosis, after an initial infection of mono prior to MS diagnosis? Is re-infection with mono a risk for MS patients? I am aware there is an MS / EBV connection but what I am interested in is what happens when a patient who already has MS tests positive for mono.
The presence or absence of EBV discovered by PCR or serological is not part of the diagnostic criteria for MS. The significance of EBV in MS is a matter of association and not causation currently. There have been many suspected infectious players in the pathogenesis of MS, with EBV among the most notable. This virus remains latent in B cells which also happen to be a significant factor in MS disease activity (the b-cell is involved in episodic bouts or inflammation or relapse) but may play a role in MS progression. At present, there isn’t clinical significance of EBV infection prior to or after MS diagnosis. This topic continues to be a subject of research.
A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente
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