False positive lyme serology due to syphilis

Topics with information and discussion about published studies related to Lyme disease and other tick-borne diseases.
Post Reply
rlstanley
Posts: 1637
Joined: Mon 3 Dec 2007 2:53

False positive lyme serology due to syphilis

Post by rlstanley » Fri 15 Apr 2011 17:23

False positive lyme serology due to syphilis: report of 6 cases and review of the literature

Naesens R, Vermeiren S, Van Schaeren J, Jeurissen A.
Department of Microbiology, GasthuisZusters Antwerpen, Antwerp, Belgium
Volume 66, issue 1 of Acta Clinica Belgica
Abstract
A 44-year-old man presented with visual field defects. Ophthalmoscopy revealed papilloedema of the left eye. Neuroborreliosis was suspected and serum was positively being tested using VIDAS® Lyme screen II (bioMerieux Vitek Inc). However, confirmatory testing using the Borrelia VlsE C6 titre was negative.

Western Blotting on serum and cerebrospinal fluid could not confirm the possible diagnosis of neuroborreliosis. VDRL and TPPA testing was positive, and finally, the diagnosis of neurosyphilis was established. We subsequently screened our database on patients with positive VIDAS Lyme screening and negative confirmatory testing by Western blot, and found another 5 cases in which Lyme screening was false positive due to cross-reactivity with Treponema pallidum antibodies.

Our data show that in patients with positive Lyme screening and negative confirmatory testing, performance of lues serology should be considered.
http://www.ncbi.nlm.nih.gov/pubmed/21485767

edit: URL for abstract added
.
Last edited by rlstanley on Tue 19 Apr 2011 16:47, edited 1 time in total.

rlstanley
Posts: 1637
Joined: Mon 3 Dec 2007 2:53

Re: False positive lyme serology due to syphilis

Post by rlstanley » Fri 15 Apr 2011 17:30

http://www.medterms.com/script/main/art ... lekey=9221

VDRL test: A blood test for syphilis (VDRL stands for Venereal Disease Research Laboratory) that detects an antibody that is present in the bloodstream when a patient has syphilis.

A negative (nonreactive) VDRL is compatible with a person not having syphilis, but in the early stages of the disease, the VDRL often gives false negative results. Conversely, a false positive VDRL can be encountered in infectious mononucleosis, lupus, antiphospholipid antibody syndrome, hepatitis A, leprosy, malaria and, occasionally, pregnancy.

http://www.pathology.uci.edu/PathologyS ... 0SERUM.htm

SYPHILIS CONFIRMATION (TP-PA), SERUM

A reactive Syphilis TP-PA (Treponema pallidum particle agglutination) result indicates infection with Treponema pallidum at an undetermined time. A nonreactive Syphilis TP-PA in nonimmunocompromised patients should rule out active Syphilis except in early primary infection. Syphilis TP-PA antibodies may persist for many years and sometimes for life in treated, cured patients. For patients that have Equivocal Syphilis TP-PA results, the Fluorescent Treponemal Antibody-Absorption Double Staining (FTA-ABS-DS) assay will be performed. This assay is more sensitive in cases of untreated early primary syphilis.

5vforest
Posts: 10
Joined: Sat 12 Mar 2011 2:56

Re: False positive lyme serology due to syphilis

Post by 5vforest » Fri 15 Apr 2011 17:48

Is it possible to have late-stage Syphilis without ever having chancres?

Claudia
Posts: 1448
Joined: Wed 14 Nov 2007 1:19
Location: Connecticut, USA

Re: False positive lyme serology due to syphilis

Post by Claudia » Fri 15 Apr 2011 18:21

I remember when my son, 17 years old at the time, was first evaluated for suspected Lyme disease and so many vials of blood were being drawn at the initial appointment for the extensive lab work-ups being done. I saw on the billing statement that one of the tests was for syphilis and being a little taken aback by that. I did realize at the time that a good physician will work to rule in/out all possible alternative diagnosis, and that Bb and T. pallidum are related bacterium, but this just goes to show one more very important reason that seeing a real medical doctor, one that does a thorough patient evaluation, is extremely important if Lyme disease is suspected. Ugh, syphilis.

rlstanley
Posts: 1637
Joined: Mon 3 Dec 2007 2:53

Re: False positive lyme serology due to syphilis

Post by rlstanley » Fri 15 Apr 2011 18:57

5vforest wrote:Is it possible to have late-stage Syphilis without ever having chancres?
If you search, you will find information that chancres can be overlooked depending on where they are located. Women are more likely to overlook them if they are painless and in hidden spots of their genitalia. Oral chancres are painful and less likely to overlook.

http://www.aafp.org/afp/2003/0715/p283.html

http://www.wisegeek.com/what-is-oral-syphilis.htm

http://books.google.com/books?id=Qt4QYz ... ok&f=false

Post Reply