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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 infection.
Heterophile antibodies can arise in non-EBV infections. False positive monospot tests may occur in cases of HIV, lymphoma, or systemic lupus erythematosus. Other assays for detection of EBV are available, including serologic markers. [7] An important clinical pearl for heterophile antibodies is they can also be seen in genetic immunodeficiencies.
When caused by EBV, infectious mononucleosis is classified as one of the Epstein–Barr virus–associated lymphoproliferative diseases. Occasionally the disease may persist and result in a chronic infection. This may develop into systemic EBV-positive T cell lymphoma. [30]
The disease develops as a complication or progression of either Epstein–Barr virus-positive infectious mononucleosis (EPV+ IM) or chronic active Epstein–Barr virus infection (CAEBV)., [1] that is, as a worsening of the signs/symptoms some three weeks after the onset of an EBV+ IM-like disease or an any time during the course of CAEBV.
Epstein–Barr virus snoRNA1 is a box CD-snoRNA generated by the virus during latency. V-snoRNA1 may act as a miRNA-like precursor that is processed into 24 nucleotide sized RNA fragments that target the 3'UTR of viral DNA polymerase mRNA. [39] ebv-sisRNA: latent Ebv-sisRNA-1 is a stable intronic sequence RNA generated during latency program III.
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.
False positives "can happen with any test" and, if someone tests positive for COVID-19 with a rapid test but does not have symptoms, he recommends following up with a PCR test to confirm that this ...
EBV-positive multiple myeloma is classified by the World Health Organization (2016) as one form of the Epstein–Barr virus-associated lymphoproliferative diseases and termed Epstein–Barr virus-associated plasma cell myeloma. EBV-positive disease is more common in the plasmacytoma rather than multiple myeloma form of plasma cell cancer. [46]