sup] However, the Hoagland criteria state that in patients presenting with clinically suspected infectious mononucleosis, the diagnosis should be confirmed using the heterophile antibody
Although heterophile antibody
test is not sensitive, the positive result can reject the need for further investigation.
The ghost in the assay tube: heterophile antibody
interferences in immunoassays - an ever-recurring but often forgotten problem.
Initial testing with a CBC--looking for atypical lymphocytes (which after several days replace the early granulocytic response) and a heterophile antibody
titer--is a reasonable strategy.
When the mononucleosis is on its way toward resolution, the heterophile antibody
and the IgM VCA may be positive or negative, IgG VCA will be positive (and will remain so for life), but EBNA still will be negative.
Evaluation for heterophile-blocking antibodies with the Scantibodies Heterophilic Blocking Tube in serum did not alter the TSH results, suggesting the absence of heterophile antibody
Laboratory findings Complications Atypical lymphocytosis Sensitive but not specific Positive heterophile antibody
Not accurate in young children (Monospot) test High levels of anti-VCA IgM May cross-react with rheumatoid factor Raised liver enzymes (AST, ALT) Sensitive but not specific
The AxSYM [beta]-human chorionic gonadotropin assay has previously been shown to be subject to heterophile antibody
interference in several female patients.
A rapid slide test for heterophile antibody
infectious mononucleosis was positive.
Unless a prolactin immunoassay has been confirmed to be free of this interference, a heterophile antibody
is suspected if test results are inconsistent with the clinical picture.
Rather, it detects heterophile antibody
, a low-affinity, highly cross-reactive IgM produced when EBV infects uncommitted B cells.
Tsaparas et al published an interesting study describing a cost-effective algorithm for evaluating patients with suspected infectious mononucleosis (IM) and negative heterophile antibody
rheumatoid factor, rapid plasma reagin, ASO, human chorionic gonadotropin [hCG], heterophile antibody
When is a heterophile antibody
not a heterophile antibody