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Serologic Tests for Syphilis and the False-Positive Reactor

Serologic Tests for Syphilis and the False-Positive Reactor Abstract The role of treponemal and nontreponemal tests in the serodiagnosis of syphilis is reviewed. Diagnostic problem cases should be evaluated by treponemal tests to distinguish latent syphilis from false-positive reactions. A comparison of treponemal tests performed on serum from 101 late latent and tertiary syphilitics showed that the fluorescent treponemal antibody absorption (FTA-ABS) test is more sensitive than the Treponema pallidum immobilization (TPI) or FTA-200 tests. Objective evidence of late syphilis was present in 6 of 11 patients with discordant test results (TPI nonreactive; FTA-ABS reactive). Of the 50 chronic false-positive reactors studied, 24 had evidence of lupus erythematosus or another of the autoimmune diseases. References 1. Fiumara, J.J.: Biologic False-Positive Reaction for Syphilis: Massachusetts 1954-1961 , New Eng J Med 268:402-405, 1963.Crossref 2. Bradford, L.L., et al: FTA-200, FTA-ABS, and TPI Tests in Serodiagnosis of Syphilis , Public Health Rep 80:797-804, 1965.Crossref 3. Sequeira, P.J.L.: Serology of the Venereal Diseases , Brit J Vener Dis 38:9, 1962. 4. Laurell, A.B., and Lindau, A.: Studies on the Electrophoretic Mobility of the Wassermann Reagins in Different Stages of Syphilis , Acta Path Microbiol Scand 42:67-74, 1958.Crossref 5. Portnoy, J., et al: Fractionation Studies of Antibodies Detected in Serological Tests for Syphilis: A Preliminary Report , Brit J Vener Dis 39:33-36, 1963. 6. Serologic Tests for Syphilis , Venereal Disease Research Laboratory, publication 411, US Public Health Service, 1964. 7. Rein, C.R.; Kelcec, L.C.; and Rosenfield, T.M.: The Role of Sitolipin in Serologic Tests for Syphilis , Amer J Syph 35:573-577, 1951. 8. McKay, I.R.: An Autoimmune Reaction Against Human Tissue Antigens in Certain Acute and Chronic Diseases: II. Clinical Correlations , Arch Intern Med 101:30-46, 1958.Crossref 9. Sulzberger, M.B.: Dermatologic Allergy , Springfield, Ill: Charles C Thomas, 1940, p 295. 10. Gillespie, E.J., and Brown, B.C.: New Laboratory Methods in the Diagnosis and Management of Syphilis , Med Clin N Amer 48:731-741, 1964. 11. Nelson, R.A., Jr., and Mayer, M.M.: Immobilization of Treponema pallidum in Vitro by Antibody Produced in Syphilitic Infection , J Exp Med 89:369-393, 1949.Crossref 12. Eng, J., and Wereide, K.: TPI Test in Untreated Syphilis: A Serological Re-Examination of 50 Patients Belonging to the "Oslo Study of Untreated Syphilis," Brit J Vener Dis 38:223-229, 1962. 13. Hederstedt, B., and Skog, E.: Clinical Importance of Persistent T pallidum Immobilizing (TPI) Activity in Treated Syphilis Cases, Nonreactive to Reagin Tests (STS) , Acta Dermatovener 44:122-126, 1964. 14. Deacon, W.E.; Falcone, V.H.; and Harris, A.: A Fluorescent Test for Treponemal Antibodies , Proc Soc Exp Biol Med 96:477-480, 1957.Crossref 15. Deacon, W.E.; Freeman, E.M.; and Harris, A.: Fluorescent Treponemal Antibody Test: Modification Based on Quantitation (FTA-200) , Proc Soc Exp Biol Med 103:827-829, 1960.Crossref 16. Hunter, E.F.; Deacon, W.E.; and Meyer, P.E.: An Improved FTA Test for Syphilis: The Absorption Procedure (FTA-ABS) , Public Health Rep 79:410-412, 1964.Crossref 17. Moore, J.E., and Mohr, C.F.: Biologically False-Positive Tests for Syphilis: Type, Incidence, and Cause , JAMA 150:467-473, 1952.Crossref 18. Fiumara, N.J.: Problem of the Biologic False-Positive Reaction , Proceedings, World Forum on Syphilis and Other Treponematoses , publication 997, US Public Health Service, 1964, pp 262, 268. 19. Wuepper, K.D., and Tuffanelli, D.L.: False-Positive Reaction to VDRL Test With Prozone Phenomena: Association With Lymphosarcoma , JAMA 195:868-869, 1966.Crossref 20. Konstant, G.H.: Serology of Syphilis in the Newborn and Infant , Derm Dig vol 3, No. (6) , June 1964. 21. Harvey, A. McG.: Autoimmune Disease and the Chronic Biologic False-Positive Test for Syphilis , JAMA 182:513-518, 1962.Crossref 22. Catterall, R.D.: Collagen Disease and the Chronic Biological False-Positive Phenomenon , Quart J Med 30:41-55, 1961. 23. Knight, A., and Wilkinson, R.D.: Clinical Significance of the Biological False-Positive Serologic Reactor , Canad Med Assoc J 88:1193-1195, 1963. 24. Putkonen, T.: Biologic False-Positive Seroreactions for Syphilis , Acta Dermatovener 148:148-155, 1965. 25. Haserick, J.R., and Long, R.: Systemic Lupus Erythematosus Preceded by False-Positive Serologic Tests for Syphilis: Presentation of Five Cases , Ann Intern Med 37:559-565, 1952.Crossref 26. Cannon, J.F.: Congenital Biologic False-Positive Serologic Tests for Syphilis , Arch Intern Med 101:620-622, 1958.Crossref 27. Putkonen, T., and Lassus, A.: Familial Occurrence of Chronic Biologic False-Positive Seroreactions for Syphilis , Dermatologica 130:332-339, 1965.Crossref 28. Tuffanelli, D.L.: Aging and False-Positive Reactions for Syphilis , Brit J Ven Dis , to be published. 29. Litwin, S.D., and Singer, J.M.: Studies of the Incidence and Significance of Anti-Gamma Globulin Factors in the Aging , Arthritis Rheum 8:538-550 1965.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Serologic Tests for Syphilis and the False-Positive Reactor

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1966.01600260044004
Publisher site
See Article on Publisher Site

Abstract

Abstract The role of treponemal and nontreponemal tests in the serodiagnosis of syphilis is reviewed. Diagnostic problem cases should be evaluated by treponemal tests to distinguish latent syphilis from false-positive reactions. A comparison of treponemal tests performed on serum from 101 late latent and tertiary syphilitics showed that the fluorescent treponemal antibody absorption (FTA-ABS) test is more sensitive than the Treponema pallidum immobilization (TPI) or FTA-200 tests. Objective evidence of late syphilis was present in 6 of 11 patients with discordant test results (TPI nonreactive; FTA-ABS reactive). Of the 50 chronic false-positive reactors studied, 24 had evidence of lupus erythematosus or another of the autoimmune diseases. References 1. Fiumara, J.J.: Biologic False-Positive Reaction for Syphilis: Massachusetts 1954-1961 , New Eng J Med 268:402-405, 1963.Crossref 2. Bradford, L.L., et al: FTA-200, FTA-ABS, and TPI Tests in Serodiagnosis of Syphilis , Public Health Rep 80:797-804, 1965.Crossref 3. Sequeira, P.J.L.: Serology of the Venereal Diseases , Brit J Vener Dis 38:9, 1962. 4. Laurell, A.B., and Lindau, A.: Studies on the Electrophoretic Mobility of the Wassermann Reagins in Different Stages of Syphilis , Acta Path Microbiol Scand 42:67-74, 1958.Crossref 5. Portnoy, J., et al: Fractionation Studies of Antibodies Detected in Serological Tests for Syphilis: A Preliminary Report , Brit J Vener Dis 39:33-36, 1963. 6. Serologic Tests for Syphilis , Venereal Disease Research Laboratory, publication 411, US Public Health Service, 1964. 7. Rein, C.R.; Kelcec, L.C.; and Rosenfield, T.M.: The Role of Sitolipin in Serologic Tests for Syphilis , Amer J Syph 35:573-577, 1951. 8. McKay, I.R.: An Autoimmune Reaction Against Human Tissue Antigens in Certain Acute and Chronic Diseases: II. Clinical Correlations , Arch Intern Med 101:30-46, 1958.Crossref 9. Sulzberger, M.B.: Dermatologic Allergy , Springfield, Ill: Charles C Thomas, 1940, p 295. 10. Gillespie, E.J., and Brown, B.C.: New Laboratory Methods in the Diagnosis and Management of Syphilis , Med Clin N Amer 48:731-741, 1964. 11. Nelson, R.A., Jr., and Mayer, M.M.: Immobilization of Treponema pallidum in Vitro by Antibody Produced in Syphilitic Infection , J Exp Med 89:369-393, 1949.Crossref 12. Eng, J., and Wereide, K.: TPI Test in Untreated Syphilis: A Serological Re-Examination of 50 Patients Belonging to the "Oslo Study of Untreated Syphilis," Brit J Vener Dis 38:223-229, 1962. 13. Hederstedt, B., and Skog, E.: Clinical Importance of Persistent T pallidum Immobilizing (TPI) Activity in Treated Syphilis Cases, Nonreactive to Reagin Tests (STS) , Acta Dermatovener 44:122-126, 1964. 14. Deacon, W.E.; Falcone, V.H.; and Harris, A.: A Fluorescent Test for Treponemal Antibodies , Proc Soc Exp Biol Med 96:477-480, 1957.Crossref 15. Deacon, W.E.; Freeman, E.M.; and Harris, A.: Fluorescent Treponemal Antibody Test: Modification Based on Quantitation (FTA-200) , Proc Soc Exp Biol Med 103:827-829, 1960.Crossref 16. Hunter, E.F.; Deacon, W.E.; and Meyer, P.E.: An Improved FTA Test for Syphilis: The Absorption Procedure (FTA-ABS) , Public Health Rep 79:410-412, 1964.Crossref 17. Moore, J.E., and Mohr, C.F.: Biologically False-Positive Tests for Syphilis: Type, Incidence, and Cause , JAMA 150:467-473, 1952.Crossref 18. Fiumara, N.J.: Problem of the Biologic False-Positive Reaction , Proceedings, World Forum on Syphilis and Other Treponematoses , publication 997, US Public Health Service, 1964, pp 262, 268. 19. Wuepper, K.D., and Tuffanelli, D.L.: False-Positive Reaction to VDRL Test With Prozone Phenomena: Association With Lymphosarcoma , JAMA 195:868-869, 1966.Crossref 20. Konstant, G.H.: Serology of Syphilis in the Newborn and Infant , Derm Dig vol 3, No. (6) , June 1964. 21. Harvey, A. McG.: Autoimmune Disease and the Chronic Biologic False-Positive Test for Syphilis , JAMA 182:513-518, 1962.Crossref 22. Catterall, R.D.: Collagen Disease and the Chronic Biological False-Positive Phenomenon , Quart J Med 30:41-55, 1961. 23. Knight, A., and Wilkinson, R.D.: Clinical Significance of the Biological False-Positive Serologic Reactor , Canad Med Assoc J 88:1193-1195, 1963. 24. Putkonen, T.: Biologic False-Positive Seroreactions for Syphilis , Acta Dermatovener 148:148-155, 1965. 25. Haserick, J.R., and Long, R.: Systemic Lupus Erythematosus Preceded by False-Positive Serologic Tests for Syphilis: Presentation of Five Cases , Ann Intern Med 37:559-565, 1952.Crossref 26. Cannon, J.F.: Congenital Biologic False-Positive Serologic Tests for Syphilis , Arch Intern Med 101:620-622, 1958.Crossref 27. Putkonen, T., and Lassus, A.: Familial Occurrence of Chronic Biologic False-Positive Seroreactions for Syphilis , Dermatologica 130:332-339, 1965.Crossref 28. Tuffanelli, D.L.: Aging and False-Positive Reactions for Syphilis , Brit J Ven Dis , to be published. 29. Litwin, S.D., and Singer, J.M.: Studies of the Incidence and Significance of Anti-Gamma Globulin Factors in the Aging , Arthritis Rheum 8:538-550 1965.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Aug 1, 1966

References