Monospot and VP1 tests in chronic fatigue syndrome and major depression

Abstract:

Thirty-four patients with chronic fatigue syndrome (CFS) were compared with controls with DSM-III-R major depression on the Monospot and VP1 antigen tests.

There was no significant difference in the numbers initially VP1 positive in the groups (11/34 and 7/34 positive in the chronic fatigue and major depression group respectively). Four CFS but no depressed patients were Monospot positive initially. No patient was both Monospot and VP1 positive. Patients positive on the tests were offered a repeat 6 months later. Eight of the 11 VP1 positive patients in the CFS group were retested and four remained positive, but none of the four depressed patients retested remained positive. No patient retested remained Monospot positive.

The Monospot and VP1 tests appear to have little discriminating ability between these groups as screening tests and their predictive validity is unclear.

 

Source: Lynch SP, Seth RV, Main J. Monospot and VP1 tests in chronic fatigue syndrome and major depression. J R Soc Med. 1992 Sep;85(9):537-40. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1293640/ (Full article)

 

Postviral syndrome–how can a diagnosis be made? A study of patients undergoing a Monospot test

Abstract:

Eighty-nine of 150 patients having a Monospot test filled out a questionnaire about their illness, and the General Health Questionnaire. They completed a follow-up questionnaire 6 months later.

Twelve (8%) had a positive Monospot. Twenty-eight of 83 serum samples tested (34%) were positive for VP1 enteroviral antigen. Forty of the patients had a self limiting illness, 13 had a definite diagnosis (excepting glandular fever), 14 had a possible postviral syndrome, 10 had recurrent sore throats/flu, and 12 had a chronic non-specific illness.

Patients with a specific diagnosis were less likely to complain of aching muscles/joints, sore throat, tiredness or loss of concentration. Their GHQ scores were lower, although this just failed to reach significance (P = 0.08), and they scored significantly lower on the somatic symptoms subscale (P = 0.022). Overall 72% scored above the GHQ threshold for ‘psychological caseness’ which is higher than in other studies. Sixty-five per cent of the sample questioned at 6 months felt that their illness started with a viral infection.

The methodological problems involved in making a diagnosis of postviral syndrome are discussed.

 

Source:  Bowman SJ, Brostoff J, Newman S, Mowbray JF. Postviral syndrome–how can a diagnosis be made? A study of patients undergoing a Monospot test. J R Soc Med. 1989 Dec;82(12):712-6. http://www.ncbi.nlm.nih.gov/pubmed/2614761

Note: You may read the full article here:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1292411/