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Studies have cited the presence of heterophile antibodies

during the course of infection with infectious mononucleosis.

Reagent

Immutex is a ready-to-use, uniform suspension of

stabilized, specially treated horse erythrocytes highly

specific for heterophile antibodies associated with infectious

mononucleosis. The reagent does not react with normal

Forssman antibodies.

Each batch of reagent undergoes rigorous quality

control at various stages of manufacture for its specificity,

sensitivity and performance.

Reagent Storage and Stability

Store the reagents at 2 to 8°C. Do not freeze. The shelf-life

of the reagents is as per the expiry date mentioned on the

reagent vial labels.

Principle

Immutex is a rapid slide hemagglutination test for the

detection of heterophile antibodies. Immutex IM reagent

will agglutinate when mixed with serum containing

heterophile antibodies. No agglutination indicates

absence of heterophile antibodies.

Note

1. In vitro diagnostic reagent for laboratory and

professional use only. Not for medicinal use.

2. All the components derived from human source have

been tested for HBsAg and Anti-HIV antibodies and

found to be nonreactive. However, handle the material

as if infectious.

3. The reagents contain thimerosal 0.01% as preservative.

Avoid contact with skin or mucosa. On disposal, flush

with large quantities of water.

4. The reagent can be damaged due to microbial

contamination or on exposure to extreme temperatures.

It is recommended that the performance of reagents

should be verified with known positive and negative

controls provided with the kit.

5. Ensure resuspension of the stabilized erythrocyte

reagent before use to improve test readability by gently

inverting the vial.

6. Do not interchange vial droppers.

7. Only a clean and dry glass slide must be used. Clean

the slide with distilled water and wipe dry.

Sample Collection and Preparation

No special preparation of the patient is necessary prior to

specimen collection by approved techniques. Though fresh

serum is preferable, serum specimens stored at 2 to 8°C for

up to 24 hours, can also be used in case of delay in testing.

Do not use hemolyzed or contaminated specimens. Turbid

specimens should be centrifuged or allowed to settle and

only the clear supernatant should be used for testing.

Materials Provided with the Kit

Reagent

Immutex IM reagent, Positive Control, Negative Control.

Accessories

Glass slide with six reaction circles, sample dispensing

pipettes, mixing sticks and rubber teats.

Additional Material Required

A high intensity direct light source, stopwatch.

Test Procedure

Bring all reagents and samples to room temperature before

use.

Qualitative Method

1. Gently mix the Immutex IM reagent to resuspend the

stabilized horse erythrocyte reagent.

2. Place one drop of the sample to be tested onto one of

the reaction circles of the glass slide using a sample

dispensing pipette provided with the kit.

3. Place one drop of the positive and negative control

onto separate reaction circles of the glass slide.

4. Add one drop of Immutex IM reagent to the test

644 Concise Book of Medical Laboratory Technology: Methods and Interpretations specimen on the slide. Do not let the dropper tip touch

the liquid on the slide.

5. Add one drop of Immutex IM reagent to each of the

controls.

6. Mix with separate mixing sticks, spreading the mixture

uniformly over the entire reaction circle.

7. Immediately start the stopwatch. Rock the slide gently,

back and forth, for 2 minutes.

8. Leave the slide undisturbed on the work table for a

further 1 minute.

9. Pick up the slide at the end of 1 minute and observe for

agglutination by rocking the slide gently back and forth.

Interpretation of Results

Agglutination is a positive test result and indicates

presence of heterophile antibodies in the test specimen.

No agglutination is a negative test result and indicates

absence of heterophile antibodies in the test specimen.

Remarks

1. Markedly lipemic, hemolyzed and contaminated

serum sample could produce nonspecific results.

2. Use of plasma rather than serum can lead to false

positive results.

3. Heterophile antibodies may be found in disease

other than infectious mononucleosis. Low titers have

been detected in cytomegalic inclusion disease and

toxoplasmosis.

4. Do not read the results beyond indicated testing time

limit.

5. As with all diagnostic tests, the result of the test should

be correlated with clinical findings to arrive at the final

diagnosis.

6. The reagent performance should be validated by

occasionally running the positive and negative

controls provided with the kit.

Possible causes Solutions

1. Plasma is used as a test specimen Only serum must be used for testing. Should a delay in testing occur, store samples

at 2–8°C

2. Markedly lipemic and contaminated serum

samples could produce non-specific results

Do not use lipemic and contaminated serum samples for testing

3. Drying of the reagent on slide Do not read results beyond 3 minutes. The test should not be carried out directly under

the fan

4. In other disease conditions,

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