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Serological Findings in Infectious Mononucleosis

L. W. Kleppe, MD
JAMA. 1963;184(1):79. doi:10.1001/jama.1963.03700140135026.
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To the Editor:  —I believe exception should be taken to a portion of the reply to the question entitled "Infectious Mononucleosis" from the Questions and Answers section of The Journal (181:1156 [Sept 29] 1962). Misinterpretation of the results of the heterophil agglutination procedure with absorption does an injustice to a procedure which comes unusually close to being a pathognomonic diagnostic tool.The presumptive titer is merely a screening procedure to acquaint the serologist with those sera with which he might obtain a three-tube absorption with the Forssman and/or beef cell antigens. Therefore, any heterophil agglutination titer of 1:28 or greater should receive the benefit of the Davidsohn absorption differential. Negative results provide no information, but a positive absorption comes as close to an absolute diagnostic tool as anything we possess. An example of a low but significant titer is: presumptive, 1:28; after absorption with Forssman antigen, 1:7; after beef

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