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The mononuclear spot test or monospot test, a form of the heterophile antibody test, [1] is a rapid test for infectious mononucleosis due to Epstein–Barr virus (EBV). It is an improvement on the Paul–Bunnell test. [2] The test is specific for heterophile antibodies produced by the human immune system in response to EBV
Mono is primarily diagnosed based on the symptoms and can be confirmed with blood tests for specific antibodies. [3] Another typical finding is increased blood lymphocytes of which more than 10% are reactive. [3] [9] The monospot test is not recommended for general use due to poor accuracy. [10]
The image on the left shows a monocyte actively phagocytizing an antibody-sensitized red blood cell. The image on the right shows multiple RBC that have been phagocytized by a single monocyte. The monocyte monolayer assay (MMA) is used to determine the clinical significance of alloantibodies produced by blood transfusion recipients. [1]
Heterophile antibodies are IgM antibodies with affinity for sheep and horse red blood cells. They appear during the first week of infectious mononucleosis symptoms, 3–4 weeks after infection and return to undetectable levels 3 to 6 months after infection. Heterophile antibody is a fairly specific but insensitive test for EBV.
Blood test results for persons with infectious mononucleosis include an elevated white blood cell count, an increased percentage of atypical mononuclear cells. Liver enzymes are often elevated. A positive "mono spot" test is useful in confirming the diagnosis but a negative result does not rule out primary EBV infection.
Blood tests for monitoring could be performed if you already have a diagnosis and your physician wants to make sure the treatments are working and to check for any negative side effects, Vasagar said.
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