Internal: Deliver to lab immediately.
Offsite: Centrifuge within 30 minutes of collection. Send at 2-8 degrees C. If sample will not be tested withing 48 hours freeze at -20 degrees C.
Stability (from collection to initiation)
Refrigerated: 48 hours
Remarks
Limitations: Correlation with clinical findings is imperative since false positive and negative results have been reported. About 10% of the adult population with infectious mononucleosis will not develop heterophile antibodies. Failure to develop heterophile antibodies occurs even more frequently in children. In these instances the presence of Epstein-Barr virus antibodies may occur. Less than 2% false-positives have been reported with Hodgkin's disease, lymphoma, acute lymphocytic leukemia, infectious hepatitis, pancreatic carcinoma, CMV, Burkitt's lymphoma, rheumatoid arthritis, malaria, and rubella. Rare unexplained positive horse cell screening tests have been reported with negative differential absorptions. The infectious mononucleosis heterophile antibody appears in the serum of patients by the sixth to tenth day of illness. Highest titers are usually found in the second to third week. Anitbody levels may remain detectable for as little as 1 week or persist up to a year; usual persistence is 4-8 weeks. The level of antibody activity is not correlated with the severity of disease or the degree of lymphocytosis. A positive screening or differential test in the appropriate clinical and hematologic setting is sufficient to make the diagnosis of infectious mononucleosis. If there is clinically a mononucleosis syndrome, but the screening test is negative, consider tests for EBV specific antibodies, CMV, and toxoplasmosis antibodies.
Internal: Deliver to lab immediately.
Offsite: Centrifuge within 30 minutes of collection. Send at 2-8 degrees C. If sample will not be tested withing 48 hours freeze at -20 degrees C.
Stability (from collection to initiation)
Refrigerated: 48 hours
Remarks
Limitations: Correlation with clinical findings is imperative since false positive and negative results have been reported. About 10% of the adult population with infectious mononucleosis will not develop heterophile antibodies. Failure to develop heterophile antibodies occurs even more frequently in children. In these instances the presence of Epstein-Barr virus antibodies may occur. Less than 2% false-positives have been reported with Hodgkin's disease, lymphoma, acute lymphocytic leukemia, infectious hepatitis, pancreatic carcinoma, CMV, Burkitt's lymphoma, rheumatoid arthritis, malaria, and rubella. Rare unexplained positive horse cell screening tests have been reported with negative differential absorptions. The infectious mononucleosis heterophile antibody appears in the serum of patients by the sixth to tenth day of illness. Highest titers are usually found in the second to third week. Anitbody levels may remain detectable for as little as 1 week or persist up to a year; usual persistence is 4-8 weeks. The level of antibody activity is not correlated with the severity of disease or the degree of lymphocytosis. A positive screening or differential test in the appropriate clinical and hematologic setting is sufficient to make the diagnosis of infectious mononucleosis. If there is clinically a mononucleosis syndrome, but the screening test is negative, consider tests for EBV specific antibodies, CMV, and toxoplasmosis antibodies.
