HOLY ANGEL UNIVERSITY

School of Nursing and Allied Medical Sciences

Department of Medical Technology

IMMUNOLOGY & SEROLOGY LABORATORY WORKSHEET

Case 1
A patient has the following hepatitis B serology results:

 HBsAg: NEGATIVE
 Anti-HBs: POSITIVE
 Anti-HBc: POSITIVE

Interpret the results.  Explain and support answers.

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 Case 2
A medical scientist wants to differentiate the sera of normal patient, patient with
infectious mononucleosis(IM) and patient with serum sickness.  If the scientist will use
Paul-Bunnell Screening Test, Davidsohn Differential Test and Monoslide Test, tabulate
and explain the reactions exhibited by the following patients' sera. Support your
answers.  

Serum of Paul-Bunnell Davidsohn Differential Monoslide Test

Patient: Screening Test Test
Absorb by Absorbed
Guinea Pig by Beef
Kidney Erythrocyte
s

Normal + + - +
Patient

With + - + +
Infectious
Mononucleosi
s

With Serum + +
Sickness +
+

In the Paul-Bunnell Screening Test, a positive reaction is seen in the

serum of the patients with serum sickness and infectious mononucleosis because these
two synthesizes antibodies which are known as the heterophile antibodies which is the
reason why they are detected. In patients with infectious mononucleosis, having a titer
that is 1:56 or higher than that value is considered as suspicious and significant in
patients with this disease. On the other hand, patients with normal serum may also have
positive result due to the chance that although low levels of heterophile antibodies are
seen in the titer, these antibodies may be seen in the sera itself. Moving on to the next
test which is Davidsohn Differential Test, patients with infectious mononucleosis have a
negative reaction in the absorption of guinea pig kidney because a specific type of the
heterophile antibody is not absorbed by this kidney. This type is the IgM heterophile
antibody. However, it is positive still because it was absorved by the erythrocytes of the
beef. The one with serum sickness on the other hand is absorbed by both the guinea
pig kidney and the beef erythrocytes, hence a positive reaction is present. Lastly, the
patient with normal serum showed absorption by the kidney of the guinea pig because
the non-absorption of this aspect is a characteristic of a serum of a IM patient. It was
said that beef erythrocytes are poor in a specific type of antigen, this is the reason why
negative reaction is produced. Moving on to the last test, the Monoslide test, the result

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would be positive if the presence of a heterophile antibody is present. As stated above,
the normal patient serum may still contain heterophole antibodies, hence a positive
reaction is present. This is also the reason why the serum with IM and serum sickness
is positive in this test.

Reference/s:

Galili U. (2020). Human Natural Antibodies to Mammalian Carbohydrate Antigens as

Unsung Heroes Protecting against Past, Present, and Future Viral
Infections. Antibodies (Basel, Switzerland), 9(2), 25.
https://doi.org/10.3390/antib9020025
Santos, L., Jin, C., Mourato, C., Mendes, F., Hesse, C., & Teneberg, S. (2020).
Characterization of sheep erythrocyte glycosphingolipids recognized by
human anti-Forssman antibodies. Glycobiology, 30(11), 881–894.
https://doi.org/10.1093/glycob/cwaa032
Turgeon, M.L. (2014). Immunology and Serology in Laboratory Medicine. 5 th Edition.
Mosby, Elsevier 3251 Riverport Lane St. Louis Missouri

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