Are You Sure It's Syphilis? A Review of False Positive Serology

1995 ◽  
Vol 6 (4) ◽  
pp. 241-248 ◽  
Author(s):  
R Nandwani ◽  
D T P Evans

Summary: This article on false positive serological reactions for syphilis reviews the rapid developments which have taken place in the serodiagnosis of syphilis in recent years since the advent of the AIDS epidemic. An overview of non-specific and specific treponemal serological tests in relation to acute and chronic biological false positive reactions is followed by closer consideration of syphilis serology in the context of HIV infection, pregnancy and other conditions which may produce false positive reactions.

BMJ ◽  
1988 ◽  
Vol 296 (6630) ◽  
pp. 1194-1194 ◽  
Author(s):  
F. Nicholson ◽  
J. M Best ◽  
J E Banatvala

The Lancet ◽  
1993 ◽  
Vol 341 (8842) ◽  
pp. 441-442 ◽  
Author(s):  
IanL. Chrystie ◽  
SaraJ. Palmer ◽  
A. Voller ◽  
J.E. Banatvala

2021 ◽  
pp. 372-377
Author(s):  
Maria Giulia Cornacchia ◽  
Moris Sangineto ◽  
Rosanna Villani ◽  
Francesco Cavallone ◽  
Giuseppe Di Gioia ◽  
...  

Aim Monitoring the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) immunization in patients with autoimmune diseases is of particular concern to understand their response to the infection and to the vaccine. In fact, the immunological disorder and the immunosuppressive therapies could affect the serological response. SARS-CoV2 serological tests potentially provide this information, although they were rapidly commercialized with internal verifications. Here, we analysed the seroprevalence to SARS-CoV2 in a cohort of patients with liver autoimmune diseases. Methods From May to December 2020, a cohort of patients affected by primary biliary cholangitis (PBC), autoimmune hepatitis (AIH) and PBC/AIH overlap syndrome were screened with (reverse transcription-polymerase chain reaction) RT-PCR of nasopharyngeal swabs, rapid antigenic test and chemiluminescent serological test during routine follow-up. Results The analysis of 42 patients was carried out: 18 (42.85%) PBC, 12 (28.57%) AIH and 12 (28.57%) PBC/AIH overlap syndromes. Only 2 patients (4.76%) resulted positive to the RNA, antigen and antibody detection tests, hence affected by SARS-CoV2 infection. 14 subjects out of 40 negative cases presented a positive serology for SARS-CoV2 antibodies, hence with a false positivity in the 35% of cases without infection. Among these, 6 (42.86%) patients presented only immunoglobulin (Ig)M positivity, 6 (42.86%) patients presented positivity for only IgG and 2 (14.28%) patients were positive to both IgM and IgG. Notably, the presence of autoantibodies did not correlate with the serological false positivity, highlighting that there is no cross-reactivity with autoantibodies. The presence of polyclonal hypergammaglobulinemia did not interfere with the serological test as well. Interestingly, the patients with false positive serology showed higher levels of gamma-glutamyltransferase (GGT) and C-reactive protein (CRP). Conclusions Patients with liver autoimmune diseases present a high rate of false positive SARS-CoV2 serology. Therefore, new strategies are needed to study the serological response in this patient category.


2020 ◽  
Vol 48 ◽  
Author(s):  
Mariana Assunção De Souza ◽  
Nicolle Pereira Soares ◽  
Alessandra Aparecida Medeiros-Ronchi ◽  
Brendhal Almeida Silva ◽  
Pedro Paulo Feitosa De Albuquerque ◽  
...  

Background: Bovine tuberculosis control programs are based on a standard diagnostic method, the intradermal test with purified protein derivatives, which is used to identify and eliminate diseased animals. Currently none of the tests available allow complete differentiation between infected and uninfected animals. The main limitations of the tests available are related to diagnostic sensitivity and specificity, which results in false positive reactions due to the existence of cross infections, and also false negative, inherent to the state of energy of some animals. The aim of this work was to study the intercurrence of paratuberculosis in tuberculosis reactive cattle by the comparative cervical test.Materials, Methods & Results: Three hundred and thirty four cattle were evaluated using the comparative cervical test (CCT) and serology for tuberculosis (TB) and paratuberculosis (PTB) ELISA IDEXX®. All of the animals testing positive by CCT were euthanized and necropsied. Fragments of lymph node, lung and intestine were collected and analyzed using histopathological techniques, with staining by Hematoxylin-Eosin (HE). Samples of lung and lymph nodes (retropharyngeal, submandibular, cervical and mediastinal) of the animals testing positive by CCT were evaluated using qPRC for M. bovis, and intestinal and mesenteric lymph nodes using PCR for PTB. Of the 334 cattle evaluated using the comparative cervical test, 16 were considered positive. No lesions suggestive of tuberculosis were found in the macroscopic inspection of the carcasses. The most evident anatomical and pathological finding was a thickening of intestinal mucosa, found in 12 of the 16 cattle submitted to necropsy. No microscopic lesions suggestive of TB were identified nor was the presence of M. bovis detected by qPCR. The main histopathological findings were observed in the small intestine and mesenteric lymph nodes and identified as enteritis, lymphangitis, lymphangiectasia and granulomatous lymphadenitis. In the intestine the changes are characterized by dilated and inflamed lymphatic vessels and intense inflammatory infiltrate on the mucosa and submucosa. Of the 334 serum samples evaluated, the M. bovis ELISA Antibody Test (IDEXX®) identified 17 positive animals. All the cattle considered positive by M. bovis ELISA were considered negative by CCT. In the samples from nine animals (9/16), DNA from M. avium subsp. paratuberculosis (MAP) was identified and in twelve carcasses (12/16) lesions characteristic of PTB were found, which were subsequently confirmed by histopathological techniques. In another nine animals of the herd anti-MAP antibodies were detected. None of those that tested positive by PTB ELISA were reactive by CCT.Discussion: Animals considered positive by TB ELISA that were not positive in the intradermal test does not mischaracterize the clinical picture of the disease. Considering the inverse relationship between cell-mediated and humoral responses to M. bovis, the intradermal test and the serological tests are designed to measure different immunological responses, which develop during different stages of infection. The progress of the cellular immunological response to humoral immunity occurs in the most advanced stages of tuberculosis. Of the 16 cattle considered positive by CCT, 12 animals presented macroscopic and histological lesions suggestive of PTB and DNA from MAP was detected in nine. Although it is the official test for the control of TB in different countries, the intradermal test with PPD has presented limitations, primarily related to specificity. M. avium subsp. Paratuberculosis is considered the main cause of false positive reactions in the intradermal test. The PPD bacterial extract is a complex mixture of proteins, lipids, sugars and nucleic acids, and many of these components are also shared by numerous species of mycobacteria (tuberculous or not). 


2020 ◽  
Vol 49 (2) ◽  
pp. 179-184
Author(s):  
Anneke Feberwee ◽  
Remco Dijkman ◽  
Jeanine Wiegel ◽  
Christiaan ter Veen ◽  
Hanneke Bataille ◽  
...  

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%).


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