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Use of Nontreponemal Tests in the Diagnosis of Syphilis

Use of Nontreponemal Tests in the Diagnosis of Syphilis Abstract Following the recent article by Jurado et al1 regarding the prozone reaction in secondary syphilis, we would like to report our experience of the potential problems associated with the use of nontreponemal antibody tests to screen for treponemal infections. Report of Cases. Case 1. A 47-year-old man presented with a history of progressive cerebellar signs. There was no history of syphilis. The routine antitreponemal IgG enzyme immunoassay screening test (Captia Syphilis G) showed a positive result with an antibody index of 3.12. Confirmatory testing revealed a negative qualitative VDRL test result, a positive Treponema pallidum hemagglutination assay titer of 10 240, a positive fluorescent treponemal antibody absorbed test result, and a positive antitreponemal IgM enzyme immunoassay (Captia Syphilis M) with an antibody index of 1.2. Repeated VDRL testing, using diluted serum samples, gave a titer of 64, suggesting that the initial false-negative result was attributable to the prozone phenomenon References 1. Jurado RL, Campbell J, Martin PD. Prozone phenomenon in secondary syphilis: has its time arrived? Arch Intern Med. 1993;153:2496-2498.Crossref 2. Luger AFH. Serological diagnosis of syphilis: current methods . In: Young H, McMillan A, eds. Immunological Diagnosis of Sexually Transmitted Diseases . New York, NY: Marcel Dekker Inc; 1988:249-274. 3. Young H, Moyes A, McMillan A, Patterson J. Enzyme immunoassay for anti-treponemal IgG . J Clin Pathol. 1992;45:37-41.Crossref 4. Berkowitz K, Baxi L, Fox HE. False-negative syphilis screening . Am J Obstet Gynecol. 1990;163:975-977.Crossref 5. Rufli T. Syphilis and HIV infection . Dermatologica . 1989;179:113-117.Crossref 6. Samuels J, Ernst A. Stat RPRs . Ann Emerg Med. 1991;20:108-109.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Use of Nontreponemal Tests in the Diagnosis of Syphilis

Archives of Internal Medicine , Volume 154 (22) – Nov 28, 1994

Use of Nontreponemal Tests in the Diagnosis of Syphilis

Abstract

Abstract Following the recent article by Jurado et al1 regarding the prozone reaction in secondary syphilis, we would like to report our experience of the potential problems associated with the use of nontreponemal antibody tests to screen for treponemal infections. Report of Cases. Case 1. A 47-year-old man presented with a history of progressive cerebellar signs. There was no history of syphilis. The routine antitreponemal IgG enzyme immunoassay screening test (Captia Syphilis G) showed a...
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References (9)

Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1994.00420220116014
Publisher site
See Article on Publisher Site

Abstract

Abstract Following the recent article by Jurado et al1 regarding the prozone reaction in secondary syphilis, we would like to report our experience of the potential problems associated with the use of nontreponemal antibody tests to screen for treponemal infections. Report of Cases. Case 1. A 47-year-old man presented with a history of progressive cerebellar signs. There was no history of syphilis. The routine antitreponemal IgG enzyme immunoassay screening test (Captia Syphilis G) showed a positive result with an antibody index of 3.12. Confirmatory testing revealed a negative qualitative VDRL test result, a positive Treponema pallidum hemagglutination assay titer of 10 240, a positive fluorescent treponemal antibody absorbed test result, and a positive antitreponemal IgM enzyme immunoassay (Captia Syphilis M) with an antibody index of 1.2. Repeated VDRL testing, using diluted serum samples, gave a titer of 64, suggesting that the initial false-negative result was attributable to the prozone phenomenon References 1. Jurado RL, Campbell J, Martin PD. Prozone phenomenon in secondary syphilis: has its time arrived? Arch Intern Med. 1993;153:2496-2498.Crossref 2. Luger AFH. Serological diagnosis of syphilis: current methods . In: Young H, McMillan A, eds. Immunological Diagnosis of Sexually Transmitted Diseases . New York, NY: Marcel Dekker Inc; 1988:249-274. 3. Young H, Moyes A, McMillan A, Patterson J. Enzyme immunoassay for anti-treponemal IgG . J Clin Pathol. 1992;45:37-41.Crossref 4. Berkowitz K, Baxi L, Fox HE. False-negative syphilis screening . Am J Obstet Gynecol. 1990;163:975-977.Crossref 5. Rufli T. Syphilis and HIV infection . Dermatologica . 1989;179:113-117.Crossref 6. Samuels J, Ernst A. Stat RPRs . Ann Emerg Med. 1991;20:108-109.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 28, 1994

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