Bornholm disease laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

Overview

In many cases of Bornholm disease, inflammatory biomarkers such as Erythrocyte sedimentation rate, C-reactive protein, and Creatine Kinase are found to be elevated. Changes in CBC have been found to vary according to the underlying causative strain. Although leukocytosis is a common finding, infection with the A4 strains can result in white cell counts ≥15000/µL. Comparatively, Coxsackie B3 has been found to cause anemia and thrombocytopenia. Live function tests including AST and ALT may be elevated but changes in electrolytes have not been observed. In the event of respiratory or cardiac complications developing, arterial blood gas and pulse oximetry may be altered.

Laboratory Tests

CBC

1. RBC: no significant changes; Coxsackie B3 has been shown to cause anemia
2. WBC: leukocytosis ( ≥15000/µL; especially in children affected with the Coxsackie A4 strain) ; very few cases have shown leukopenia but this is rare compared to the former finding
3. Platelets: no significant changes; Coxsackie B3 has been shown to cause thrombocytopenia

Electrolytes

• No significant changes

Inflammatory biomarkers

• Erythrocyte sedimentation rate: Elevated ( found to be non-specific)
• C-reactive protein: Elevated (>40 mg/L; especially in children affected with the Coxsackie A4 strain)

• Creatine Kinase: Elevated in a minority of cases

LFTs

• A few cases have been found to have mildly elevated AST and ALT.

Arterial Blood Gas

• Changes may be seen if respiratory/cardiac complications develop.

Pulse oximetry

• Changes may be seen if respiratory/cardiac complications develop.

Blood Culture

• As the underlying cause is a virus, bacterial cultures are often of little use.