heterophile antibody test


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heterophile antibody test

[′hed·ə·rə‚fīl ′an·ti‚bäd·ē ‚test]
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The diagnosis of infectious mononucleosis was based on the patient's history, physical examination, laboratory findings, serological detection, and heterophile antibody test.
Although heterophile antibody test is not sensitive, the positive result can reject the need for further investigation.
The study compared antibody levels in 139 serum specimens from patients with recent primary EBV infections (confirmed by both a positive heterophile antibody test and an EBV antibody pattern compatible with recent infection) and in 40 specimens from healthy normal controls.
Children with acute infectious mononucleosis were diagnosed by symptoms, >10% atypical lymphocytes, and a positive heterophile antibody test.
A validating cohort study compared peripheral blood samples m 181 patients aged >16 years with a clinical diagnosis of infectious mononucleosis confirmed by a positive heterophile antibody test with those from 181 similar patients with a negative test.
It is correct, that for the purposes of the algorithm, we have assumed that all persons with a positive heterophile antibody test had infectious mononucleosis and did not need to be routinely evaluated further virologically.
We appreciate Dr Tetrault's concern that the heterophile antibody test must have sufficient sensitivity and specificity for diagnosing infectious mononucleosis caused by Epstein-Barr virus (EBV).
If a patient has a negative heterophile antibody test, no atypical lymphocytes, and a normal lymphocyte count, then further virology testing would not be routinely warranted, as per our algorithm; however, clinical findings could suggest that repeat testing, further virology studies, and possibly other studies may be warranted in a small number of select patients.
There were 2 a priori routes for entry into the study, and 4 patients entered via the alternate route with the heterophile antibody test being ordered by the laboratory physician.
Figure 3 outlines the apparent simplest and most cost effective model for triaging heterophile antibody tests.
Although the heterophile antibody test may occasionally be false positive in patients with autoimmune diseases, serum sickness, pregnancy, or HIV infection, false negatives are far more frequent (about 15% overall), particularly in children who are under 4 years of age (approximately 45%).