Test ID: MONOS
Infectious Mononucleosis, Rapid Test, Serum
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Rapid confirmation of a diagnosis of infectious mononucleosis
Method Name A short description of the method used to perform the test
Agglutination
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Monospot (Screen), Serum
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Specimen Volume: 0.5 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross reject |
| Lipemia | Mild OK; Gross reject |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 14 days |
| Frozen | 14 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Infectious mononucleosis (IM) is a viral illness that involves reticuloendothelial tissue and is generally limited to children and young adults. IM is most commonly caused by Epstein-Barr virus (EBV). The disease is characterized by fever, sore throat, lymphadenopathy, headache, and fatigue, and on a symptomatic basis may be confused with other diseases.
Detectable levels of unique heterophile antibodies are produced in patients with IM.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Negative (reported as positive or negative)
Interpretation Provides information to assist in interpretation of the test results
Detectable levels of the infectious mononucleosis (IM) heterophile antibody can usually be expected to occur between the sixth and tenth day following the onset of symptoms. The level usually increases through the second or third week of illness and, thereafter, can be expected to persist, gradually declining over a 12-month period.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Approximately 10% of patients with infectious mononucleosis (IM) will have no heterophile antibody and may require Epstein-Barr virus (EBV) antibody tests to confirm the diagnosis.
False-negative results have been reported. Some of these may represent cases of IM that remain persistently seronegative for the IM heterophile antibody. However, some false-negative results have been shown to be due to a delayed IM heterophile antibody response.
IM heterophile antibody titers have been shown to persist in some cases for months and years after clinical symptoms have subsided. Conversely, IM heterophile antibodies have been detected prior to the onset of clinical symptoms. Thus, caution should be exercised in the interpretation of test results.
The IM heterophile antibody has been associated with several diseases other than IM. These include leukemia, Burkitt's lymphoma, pancreatic carcinoma, viral hepatitis, cytomegalovirus infections, and others. In these cases, it is difficult to disprove the possibility of concurrent disease states.
Some segments of the population do not produce detectable heterophile antibodies, eg, approximately 50% of children <4 years of age and 10% of adolescents.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Davidsohn I, Walker PH: The nature of heterophilic antibodies in infectious mononucleosis. Am J Clin Pathol 1935;5:445-465
2. Peter J, Ray CG: Infectious mononucleosis. Pediatr Rev 1998;19(8):276-279
Method Description Describes how the test is performed and provides a method-specific reference
The Sure-Vue Mono reagent is a suspension of polystyrene latex particles coated with a highly purified Paul-Bunnell antigen from bovine red cell membranes. The degree of purity of the antigen is such that Sure-Vue Mono only reacts with infectious mononucleosis heterophile antibodies. Latex particles allow visual observation of the antigen-antibody reaction. If infectious mononucleosis heterophile antibodies are present in serum, the latex suspension changes its uniform appearance and a clear agglutination becomes evident. (Package insert: BIOKIT Sure-Vue Mono, BIOKIT, S.A., Barcelona, Spain)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Sunday; Continuously
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
86308
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| MONOS | Infectious Mono Test, S | 31418-7 |
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