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Heterophil antibody tests

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Heterophil antibody tests such as the Paul Bunnell or Monospot tests may be used in the diagnosis of glandular fever.

Heterophil antibodies have the ability to agglutinate red blood cells of different animal species. The Paul-Bunnell test uses sheep erythrocytes; the Monospot test, horse red cells.

In infectious mononucleosis, IgM heterophil antibodies are usually detectable for the first 3 months of infection. Characteristically, they are able to agglutinate sheep erythrocytes; it is absorbed by ox red blood cell but not guinea-pig kidney cells.

The pattern of reactivity is important as it characterises the heterophil antibodies present in glandular fever from those occurring in other diseases, for example:

  • hepatitis
  • lymphoma
  • leukaemia
  • rubella
  • malaria
  • SLE
  • pancreatic carcinoma

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