False-Positive VDRL and FTA in Cerebrospinal Fluid

Madiedo, Gonzalo

doi:10.1001/jama.1980.03310070038026

Cited by 29 publications

(12 citation statements)

References 5 publications

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“…Delaney described a patient with false-positive VDRL-CSF and FTA-ABS-CSF in the setting of a patient with a spinal cord tumour. 7 Madiedo et al 8 12 It seems that most cases in the literature with a false-positive VDRL-CSF occurred in association with HIV disease or underlying malignancy. Amongst our eleven patients, one had advanced HIV disease.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, there are only a few case reports that describe this phenomenon. [6][7][8][9][10] In our study, we seek to (i) discourage clinicians from evaluating patients for neurosyphilis before establishing a serodiagnosis of syphilis, (ii) highlight the utility of CSF treponemal antibody assays in the diagnosis of neurosyphilis, (iii) describe the clinical characteristics and possible causes of biological false positives in patients with false-positive VDRL-CSF and (iv) define the clinical predictors of a true-positive VDRL-CSF based on our definition.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Biological false‐positive venereal disease research laboratory test in cerebrospinal fluid in the diagnosis of neurosyphilis – a case‐control study

Zheng

Lin

Chan

et al. 2017

Acad Dermatol Venereol

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biological false‐positive venereal disease research laboratory test in cerebrospinal fluid in the diagnosis of neurosyphilis – a case‐control study

Zheng

Lin

Chan

et al. 2017

Acad Dermatol Venereol

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“…Finally, patients had to have a reactive CSF-FTA-ABS test and no other recognized cause for the neurological illness. As a consequence of using these strict criteria, it is possible that [20,22). However, the CSF-VDRL test may be reactive in asymptomatic neurosyphilis [S, 231 and for a long time after adequate treatment of neurosyphilis [24].…”

Section: Methodsmentioning

confidence: 99%

Clinical significance of cerebrospinal fluid tests for neurosyphilis

Davis

Schmitt

1989

Annals of Neurology

134

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From 1978 to 1987, 1,665 cerebrospinal fluid (CSF) fluorescent treponemal antibody absorption (CSF-FTA-ABS) tests were performed as the screening procedure for neurosyphilis. The CSF samples from 48 patients were reactive, and the medical history and results of the CSF-Venereal Disease Research Laboratory test (CSF-VDRL) for syphilis for 38 of these patients were reviewed. Likely active neurosyphilis was diagnosed if the patient had a reactive CSF-FTA-ABS test, recent onset of neurological signs consistent with neurosyphilis, abnormal CSF, and no other recognized cause for the neurological illness. Fifteen patients were so classified. Four had a reactive CSF-VDRL test. The specificity of the CSF-VDRL in diagnosing likely active neurosyphilis was 100%, but the sensitivity was only 27%. The insensitivity of the CSF-VDRL test limits its usefulness as a screening test for neurosyphilis. The CSF-FTA-ABS test appears more sensitive for screening but is less specific than the CSF-VDRL test in distinguishing currently active neurosyphilis from past syphilis. These findings imply that clinical judgment is still essential in establishing the diagnosis of active neurosyphilis.

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“…Less specific tests such as FTA or FTA-Abs can be positive by spread ing of scrum IgG through the blood-brain barrier and even more rarely in other diseases such as the case of meningeal carcinomatosis reported by Madiedo ct al. [6].…”

Section: Discussionmentioning

confidence: 99%

Late Cutaneous Syphilis and Neurosyphilis

Schoutens¹,

Boute²,

Govaerts³

et al. 1996

Dermatology

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We report two syphilitic cases of indeterminable duration. The dramatic cutaneous lesions of the female patient, compatible with secondary-tertiary syphilis associated with a positive VDRL reaction in CSF together with the criteria of neurosyphilis in her male companion (despite normal TPHA and IgG indices), led us to treat both of them in an optimal way. The clinical and serological evolution was favourable.

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False-Positive VDRL and FTA in Cerebrospinal Fluid

Cited by 29 publications

References 5 publications

Biological false‐positive venereal disease research laboratory test in cerebrospinal fluid in the diagnosis of neurosyphilis – a case‐control study

Biological false‐positive venereal disease research laboratory test in cerebrospinal fluid in the diagnosis of neurosyphilis – a case‐control study

Clinical significance of cerebrospinal fluid tests for neurosyphilis

Late Cutaneous Syphilis and Neurosyphilis

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