DIAGNOSTIC OF INFECTIOUS MONONUCLEOSIS

Infektivna mononukleoza je virusna bolest limfnog sustava koja klinički nije toliko značajna jer rijetko izaziva tešku bolest s po život ozbiljnim komplikacijama i posljedicama. Infektivna mononukleoza uglavnom ima blagi tijek bolesti; bolest je karakterizirana umorom, vrućicom, faringitisom, nelagodom, hepatosplenomegalijom, limfoadenopatijom i probavnim neugodnostima. Bolest zahvaća najčešće djecu i adolescente slabijeg imovinsko-socijalnog statusa i djecu iz zemalja u razvoju. Prema nalazima specifičnih protutijela u serumu, 95% djece siromašnijih područja preboli ovu infekciju u predškolskoj dobi. Virusi koji uzrokuju infektivnu mononukleozu su Epstein-Barr virus i Citomegalovirus. Oni pripadaju porodici Herpesviridae. Najvažnije svojstvo ovih virusa je da uzrokuju doživotne infekcije s povremenim razdobljima reaktivacije. Bolesti se mogu pojaviti u rasponu od klinički neopaženih pa sve do zloćudnih tumora kao što su Burkittov limfom, Hodgkinov i non-Hodgkinov limfom, nazofaringealni karcinom te bolesti prilikom presađivanja solidnih organa ili koštane srži. Infektivna mononukleoza se dijagnosticira najčešće metodama neizravne dijagnostike (ELISA i ELFA metode). Pretrage se odvijaju na principu određivanjaprotutijela u serumu bolesnika. U primarnom imunosnom odgovoru javljaju se IgM protutijela koja ukazuju na akutnu infekciju imogu sedijagnosticirati između prvog i drugog tjedna od infekcije. Nakon drugog tjedna javljaju se IgG protutijela koja ukazuju na preboljenu infekciju i mogu se dijagnosticirati bilo kad, jer oni ostaju doživotno u krvi. U sekundarnom imunosnom odgovoru IgG protutijela imaju brži i jači intezitet djelovanja nego u primarnom imunosnom odgovoru zbog toga jer se izlučuju iz već postojećih memorijskih stanica koje su nastale pri prvom kontaktu sa stranim antigenom.Infectious mononucleosisis a viral disease of the lymph system, clinically not so significant because its clinical symptoms are rarely severe with life-threatening serious complications and consequences. Infectious mononucleosis is mild disease; characterized by fatigue, fever, pharyngitis, hepatosplenomegaly, lymphadenopathy and digestive discomfort. The disease affects commonly children and adolescents with low social status and children from developing countries. According to the findings of specific serum antibodies, 95% of children in developing countries get over this infection at pre-school age. Viruses that cause infectious mononucleosis are the Epstein-Barr virus and Cytomegalovirus. They belong to the Herpesviridae family. The most important characteristic of the viruses is that they cause lifelong infections with occasional reactivation periods. Diseases can range from clinically unobserved to malignant tumors such as Burkitt's lymphoma, Hodgkin's and non-Hodgkin's lymphoma, nasopharynges carcinoma, and disease in solid organ or bone marrow transplantation. The most common methods for the diagnosis of infectious mononucleosis are indirect methods(ELISA and ELFA methods). Testing is based on the antibody determination in the patient's serum. In the primary immune response, IgM antibodies occur which indicate an acute infection and can be diagnosed between the first and second week of infection. After the second week, IgG antibodies occur and indicate a past infection. IgG antibodies can be diagnosed any time because they remain in the blood for life. In the secondary immune response, IgG antibodies have a faster and stronger intensity of action than in the primary immune response because they are excreted from the memory cells that have already occurred at first contact with the foreign antigen