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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
Antibody to EBNA slowly appears 2 to 4 months after the onset of symptoms and persists for the rest of a person’s life. [10] When negative, these tests are more accurate than the heterophile antibody test in ruling out infectious mononucleosis. When positive, they feature similar specificity to the heterophile antibody test.
Heterophile antibodies can cause significant interference in any immunoassay. [3] The presence of a heterophile antibody is characterized by broad reactivity with antibodies of other animal species (which are often the source of the assay antibodies). Such antibodies are commonly referred to as human anti-animal antibodies (HAAA).
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An example of helpful cross-reactivity is in heterophile antibody tests, which detect Epstein-Barr virus using antibodies with specificity for other antigens. Cross-reactivity is also a commonly evaluated parameter for the validation of immune and protein binding based assays such as ELISA and RIA .
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For example, hemolysis, icterus, lipemia, or heterophile antibodies may confound results obtained by traditional methods such as ion-selective electrodes, enzymatic assays or immunoassays. Alternate methods such as blood gas analysers, point-of-care testing or mass spectrometry may help resolve the clinical question.
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