Infectious mononucleosis detection through monospot and Paul-Bunnel Davidson tests

Background and objectives In most of cases, Ig-M anti-I antibody is detectable in infectious mononucleosis patients both through agglutination in 4-22 ° C and in high titre of antibody at 37 ° C. Our objective in this study both to evaluate the sensitivity of some serological tests and detect anti-I antibodies in diagnosis of infectious mononucleosis. Materials and Methods In this descriptive study, red blood cells of horses and sheep were used to determine heterophil antibody; monocheck kit was used for the former and Paul-Bunnell Davidson kit for the latter. Fetal OI group from umbilical cord blood was also used to determine anti-I antibody. For this purpose, we prepared different suspensions for different laboratory examinations. For serological evaluations, monospot, Paul-Bunnell Davidson, and agglutination tests were performed; moreover, manual WBC counting was performed for hematological evaluations. Results 90 patients with infectious mononucleosis were included in this study. 44% of the patients had antibody titre of more than 1/40 that was significantly more than that of the 6% of the control group. The results of the Paul–Bunnell Davidson test showed that antibody absorbtion level was more than 1/40 in 34% of the patients. In the control group, none of the subjects had antibody titre of more than 1/40. The results of the absorption of antibodies by cow RBCs showed that in 76% of cases antibody titre was zero compared to 55% in the control group. WBC counting in the majority of the patients with positive Paul-Bunnell Davidson showed an increase up to (14-15)×109 cell/L. Lymphocytosis of more than 50% and atypical lymphocyte formation of more than 10% were also seen in the majority of these cases. Evaluation of the anti-I and anti-i antibodies showed no evidence of agglutination at the temperature of 4 ° C and 22 ° C using oi blood group of umbilical cord and OI blood group of mature red blood cells. Conclusions The results showed very good correlation between monospot and Paul-Bunnell Davidson test. Hematological results of positive Paul-Bunnel Davidson showed remarkable changes in WBC count, lymphocytosis, and atypical lymphocyte formation. With the exposure of oi cord blood RBC to patient's plasma showed no evidence of agglutination at the temperature of 4 ° C, 22 ° C, and 37 ° C.