scholarly journals False-positive reactions in the rapid plasma reagin-card, fluorescent treponemal antibody-absorbed, and hemagglutination treponemal syphilis serology tests

1979 ◽  
Vol 9 (3) ◽  
pp. 369-372
Author(s):  
C R Peter ◽  
M A Thompson ◽  
D L Wilson

Sera from 628 nonsyphilitic individuals were tested with the Rapid Plasma Reagin-Card, Fluorescent Treponemal Antibody-Absorbed, and Hemagglutination Treponemal Test for Syphilis tests to ascertain the comparative specificity of these tests. Many sera were also tested with the quantitative Venereal Disease Research Laboratory test. Sera included in the study were from both normal individuals and patients with a variety of illnesses and conditions. The Hemagglutination Treponemal Test for Syphilis gave the lowest overall percentage of false-positive reactions (1.6%), followed by the Fluorescent Treponemal Antibody-Absorbed test (3.3%) and the Rapid Plasma Reagin-Card test (10.8%).

1976 ◽  
Vol 4 (2) ◽  
pp. 145-150
Author(s):  
J D Dyckman ◽  
R D Wende ◽  
D Gantenbein ◽  
R P Williams

A total of 1,020 serum and plasma specimens were tested using the Venereal Disease Research Laboratory (VDRL), Rapid Plasma Reagin (RPR) card, Reagin Screen (RST) and Fluorescent Treponemal Antibody-Absorption (FTA-ABS) tests. In 257 normal patients, all screening tests were nonreactive; the FTA-ABS test was reactive for one patient. In 588 patients with treated and untreated syphilis, the RST results were 91.7% in agreement with the VDRL and RPR results. In 175 patients with diseases that cause biological false reactions, the RST was 94% in agreement with the other screening tests. The titer of the RST was within one dilution of the corresponding VDRL titer in 91.7% of the 360 speciments tested and within one dilution of the RPR titer in 96.9% of 358 specimens quantitated by both tests.


2005 ◽  
Vol 16 (11) ◽  
pp. 722-726 ◽  
Author(s):  
Alexandra Geusau ◽  
Harald Kittler ◽  
Ulrike Hein ◽  
Edda Dangl-Erlach ◽  
Georg Stingl ◽  
...  

This retrospective study on syphilis screening at the sexually transmitted infection (STI) unit of a University Department emphasizes the necessity of a treponemal-specific test as the appropriate screening test. The Venereal Disease Research Laboratory (VDRL) test for syphilis screening may, under certain circumstances, yield positive results in patients not infected with Treponema pallidum, a phenomenon referred to as biological false-positive (BFP) VDRL test. The aim of this study was to determine the frequency of BFP tests in a large sample of sera. In this retrospective study, we analysed the results of parallel VDRL and T. pallidum haemagglutination (TPHA) testing of a total of 514,940 blood samples obtained from patients at the Vienna General Hospital between January 1988 and November 1999. Patients' sera with incomplete data on stage and sex and duplicate sera were excluded, leaving 300,000 sera for analysis. The seroprevalence for syphilis was 1.77% ( n = 5320), as determined by a positive TPHA test. It was significantly higher in male than in female patients (2.03% versus 1.58%, P<0.001). Of the patients reactive in the TPHA test, 3257 (61.2%) were negative in the VDRL. With regard to reactivity in VDRL testing, 2799 patients (0.92%) of the study population were positive, of whom 736 (26%) were biological false positive. BFP reactivity was found in 0.24% of all patients and was significantly higher in women than in men (0.27% versus 0.20%, P<0.001) and in patients over 60 years of age (0.34%) as compared with those under 60 (0.25%, P<0.001). This proportion might be even higher, as reactivity in the VDRL at 1:0 and 1:2 dilutions without a positive treponemal test was not reported. The subgroup of HIV-positive patients ( n = 1415) revealed a 10-fold higher rate of BFP tests (2.1% versus 0.24), an effect being statistically significant. In a low syphilis prevalence population, BFP reactions comprise a high proportion of all VDRL reactors. Therefore, the use of the VDRL as a screening procedure is challenged.


2020 ◽  
Vol 3 (1) ◽  
pp. 73-83
Author(s):  
Hari Darmawan ◽  
Izazi Hari Purwoko ◽  
Mutia Devi

Sifilis adalah penyakit infeksi menular seksual disebabkan bakteri Treponema pallidumdapat ditularkan melalui hubungan seksual, transfusi darah, dan vertikal dari ibu ke janin.  Jika perempuan hamil menderita sifilis dapat terjadi infeksi transplasenta ke janin sehingga menyebabkan keguguran, lahir prematur, berat badan lahir rendah, lahir mati, atau sifilis kongenital. Diagnosis sifilis pada kehamilan ditegakkan berdasaranamnesis,manifestasi klinis, pemeriksaanlaboratorik, danserologik. Skrining pada trimester pertama dengan tes non-treponema seperti rapid plasma reagin(RPR) atau venereal disease research laboratory(VDRL) kombinasi dengan tes treponema seperti treponema pallidum hemagglutination assay(TPHA) merupakan hal penting pada setiap perempuan hamil. Manifestasi klinis sifilis ke janin bergantung pada usia kehamilan dan stadium sifilis maternal serta respons imun janin. Deteksi dini dan terapi adekuat penting untuk mencegah transmisi infeksi sifilis dari ibu ke janin.


2012 ◽  
Vol 39 (6) ◽  
pp. 453-457 ◽  
Author(s):  
Christina M. Marra ◽  
Lauren C. Tantalo ◽  
Clare L. Maxwell ◽  
Emily L. Ho ◽  
Sharon K. Sahi ◽  
...  

2015 ◽  
Vol 48 (2) ◽  
pp. S130 ◽  
Author(s):  
Yu-Jung Tung ◽  
Min-ham Hsieh ◽  
Chun-Yu Lin ◽  
Yen-Hsu Chen ◽  
Chung-Hao Huang

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S239-S240
Author(s):  
Terin Sytsma ◽  
Elitza Theel ◽  
Zelalem Temesgan ◽  
Michel Toledano

Abstract Background The Venereal Disease Research Laboratory (VDRL) test performed in cerebrospinal fluid (CSF) is considered highly specific for the diagnosis of neurosyphilis, but algorithms to diagnose neurosyphilis require positive syphilis serologic testing prior to obtaining CSF-VDRL. Inappropriate use of diagnostic tests depletes healthcare resources, and contributes to rising healthcare expenditures. CSF-VDRL has historically been improperly utilized; however there is no recent evaluation of its use in clinical practice. We aimed to quantify rates of appropriate CSF-VDRL testing, determine the CSF-VDRL false-positivity rate and describe causes of false-positive CSF-VDRL reactivity. Methods In this retrospective cohort study of three Mayo Clinic sites (Rochester, MN, Jacksonville, FL, and Scottsdale, AZ), we measured the rate of appropriate CSF-VDRL test utilization in patients with negative testing from January 1, 2011 to December 31, 2017. We then identified all patients with positive CSF-VDRL testing from January 1, 1994 to February 28, 2018, characterized true- and false-positive rates and described causes of CSF-VDRL false-positivity. Results Among 8,553 persons with negative CSF-VDRL results, testing was unnecessarily ordered in 8,399 (98.2%). The word “syphilis” or “neurosyphilis” appeared in the notes of only 1,184 (13.8%) individuals with a negative CSF-VDRL result. From January 1994 through February 2018, 33,933 CSF-VDRL tests were performed on 32,626 individual patients. Among 60 positive CSF-VDRL results, 41 (68.3%) were true-positives, 2 (3.3%) were indeterminate, and 17 (28.3%) were false-positives. Every patient with true-positive CSF-VDRL had positive serologic syphilis testing prior to CSF testing. All patients with false-positive CSF-VDRL results were inappropriately tested. Neoplastic meningitis was a common cause of false-positive CSF-VDRL results. Conclusion This is the first study in decades to review CSF-VDRL utilization for the diagnosis of neurosyphilis. Inappropriate use of CSF-VDRL testing for diagnosis of neurosyphilis remains problematic in clinical practice. Following recommended testing algorithms would prevent unnecessary testing, preserve resources, and minimize false-positive results. Disclosures All Authors: No reported disclosures


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