Hi everyone,

For all you smart guys and gals out there, please help me make sense of this:

51-year-old RN, received three hepatitis B immunizations in approximately 1995. Patient has been having fibromyalgia like symptoms, minimal if any objective joint findings, as well as depression, sent her to a rheumatologist. He did a mega workup, including hepatitis tests. Here's what came back:

Normal liver function tests, AST 17, ALT 13
Normal sed rate and CRP

Hep B e Antigen REACTIVE
Hep B S Ag nonreactive
Hep B S Ab nonreactive
Hep B Core Ab nonreactive
Hep B Core IgM Ab nonreactive
Hep B e Ab nonreactive

Thinking this was a lab error, I repeated the tests, which were repeated eight days later. The results were the same.

I have had virtually no experience with hepatitis B since residency, many many moons ago. I can't understand how, based on usually published charts, e antigen could be the only positive test.

I'm going to send her to gastroenterologist, but I'd like some insight as to just what's going on.

Thank you!

Gene

Gene Nallin MD solo family practice with one PA Cumberland, Md