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Canadian Medical Association journal1974; 110(7); 793-802;

Limitations of immunofluorescence tests in the diagnosis of infectious mononucleosis.

Abstract: The relative value of heterophil agglutinins (HA) and of specific EBV antibodies in the diagnosis of infectious mononucleosis (IM) was assessed in 108 cases of the disease and in 280 controls. Among the 108 cases 93 were HA-positive by sheep cells in at least one of their sera, while 15 were HA-negative by the same test. Among the 280 controls false-positive HA tests were not encountered except in eight cases with the horse cell microtitre tests. With one of the two slide tests at least two false-positive tests and 12 false-negative tests were also found but these sera had low titres in microtitre tests. The HA life-span was found to be unexpectedly long in a few cases, sheep cell HA lasting up to 8 to 10 months and horse cell HA up to 21 to 23 months.Many false-positive tests may therefore not be true false-positives and may result from the persistence of HA following unrecognized mononucleosis months before. Virtually all cases of IM had (or developed) antibodies to Epstein-Barr virus, viral capsid antigen (EBV-VCA), whereas only half of the controls were EBV-VCA-positive. The comparative analysis of nonspecific and specific test results in mononucleosis allows the following conclusions: (1) horse cell microtitre tests and the monospot test are more sensitive than sheep cell microtitre tests and the monotest; (2) false-negative results are occasionally seen with the latter tests but not with the former; (3) more false-positive results, however, are probably seen with the former tests; and (4) specific EBV-IgM and EBV-EA antibody tests are useful in the diagnosis of selected borderline cases of mononucleosis.
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Publication Date: 1974-04-06 PubMed ID: 4363398PubMed Central: PMC1947468
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  • Comparative Study
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article focuses on the efficacy of different diagnostic tests for infectious mononucleosis (IM) by examining the presence of specific antibodies in patients and control groups. The researchers found that the antibody lifespan in some cases could last significantly longer than previously assumed. Additionally, while the horse cell microtitre tests and the monospot test were more sensitive, they also produced more false-positive results. Using specific Epstein-Barr virus (EBV) antibodies tests proved helpful in diagnosing borderline cases of mononucleosis.

Research Methodology

  • The researchers conducted the study on 108 cases and 280 controls. They assessed the relative effectiveness of heterophil agglutinins (HA) and specific EBV antibodies as diagnostic measures for infectious mononucleosis (IM).
  • Among the 108 cases, 93 were HA-positive through testing with sheep cells, while 15 were HA-negative. Meanwhile, false-positive HA tests within the control group were rare, barring eight cases when tested with horse cells.

Findings on HA Lifespan and Prevalence of False Positives

  • The researchers uncovered longer HA lifespans in some cases, with sheep cell HA lasting up to 8 to 10 months and horse cell HA lasting up to 21 to 23 months.
  • The higher prevalence of false-positive tests may not be genuinely false-positives but could be resulting from the retention of HA following unrecognized mononucleosis months earlier.

Analysis of EBV-IgM antibodies

  • Almost all cases of IM had or developed antibodies to Epstein-Barr Virus (EBV), specifically the viral capsid antigen (EBV-VCA), while only half of the control group was EBV-VCA-positive.
  • Specific EBV-IgM and EBV-EA antibody tests were found to be useful in diagnosing borderline cases of mononucleosis.

Comparison of Tests

  • Comparative analysis of the non-specific and specific test results led to several conclusions. This included the observation that horse cell microtitre tests and the monospot test are more sensitive than sheep cell microtitre tests and the monotest.
  • However, the more sensitive tests (horse cell microtitre tests and the monospot test) may result in more false-positive results.
  • False-negative results were occasionally observed with the less sensitive tests (sheep cell microtitre tests and the monotest) but not with the more sensitive tests.

Cite This Article

APA
Joncas JH, Gilker JC, Chagnon A. (1974). Limitations of immunofluorescence tests in the diagnosis of infectious mononucleosis. Can Med Assoc J, 110(7), 793-802.

Publication

Canadian Medical Association journal
ISSN: 0008-4409
NlmUniqueID: 0414110
Country: Canada
Language: English
Volume: 110
Issue: 7
Pages: 793-802

Researcher Affiliations

Joncas, J H
    Gilker, J C
      Chagnon, A

        MeSH Terms

        • Adult
        • Agglutinins / analysis
        • Animals
        • Antibodies, Heterophile / analysis
        • Antibodies, Viral / analysis
        • Antibody Formation
        • Antigens, Viral / analysis
        • Burkitt Lymphoma / immunology
        • Burkitt Lymphoma / pathology
        • Cell Line
        • Cytomegalovirus / immunology
        • Erythrocytes / immunology
        • False Negative Reactions
        • False Positive Reactions
        • Fluorescent Antibody Technique
        • Goats / immunology
        • Herpesvirus 4, Human / immunology
        • Horses / immunology
        • Humans
        • Immunoglobulin M / analysis
        • Infectious Mononucleosis / blood
        • Infectious Mononucleosis / diagnosis
        • Infectious Mononucleosis / immunology
        • Lymphocytes / immunology
        • Rabbits / immunology
        • Sheep / immunology

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        Citations

        This article has been cited 2 times.
        1. Joncas JH, Wills A, Reece E, Fox Z. Epstein-Barr virus antibodies in patients with ataxia-telangiectasia and other immunodeficiency diseases. Can Med Assoc J 1981 Oct 15;125(8):845-9.
          pubmed: 6272957
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