In addition, although treponemal
antibody titers indicate exposure to syphilis and are not considered useful in the diagnosis and management of the disease, in this study, every twofold increase in TPPA titer was associated with a 60% increase in the odds of congenital syphilis.
Reverse sequence screening algorithm is provided by the Centers for Disease Control and Prevention (CDC) in which a specific treponemal
test like ELISA/CLIA is performed first, followed by testing reactive sera with non treponemal
test like RPR or VDRL.
When reactive VDRL is present, it is recommended, if possible, to carry out a treponemal
test on the pregnant woman as well as on her partner(s) and, if non-reactive, to discard the hypothesis of syphilis and consider instead the possibility of a cross-reaction caused by pregnancy and other infections (33).
Recently new treponemal
tests using chemiluminescence technology, like Architect Syphilis TP (CMIA) (Architect i2000, Abbott, Tokyo, Japan), for the detection of specific antibodies were introduced into the market.
Syphilis infection can be diagnosed using either the treponemal
or the nontreponemal approach.
Burada annesi sifiliz tanisiyla yetersiz tedavi almis, makulopapuler dokuntulerle basvuran maternal treponemal
testi pozitif saptanarak erken konjenital sifiliz tanisiyla basariyla tedavi edilen yenidogan hasta sunulmaktadir.
b) Las pruebas treponemicas, donde se utiliza el antigeno del microrganismo para detectar el anticuerpo especifico contra el Treponema pallidum, siendo la mas usada la fluorescent treponemal
antibody absorption (FTAABS) [11,12].
The patientwas found to have a CD4 count of 101 cells/[mm.sup.3] (22%), an HIV viral load of 2,735,060 copies/mL, a reactive treponemal
antibody, and a positive rapid plasma reagin (RPR) titer at 1:64.
(2,3) Traditionally, the immunologic syphilis screening algorithm begins with a nontreponemal immunoassay (eg, rapid plasma reagin [RPR]), and if this result is positive, then the specimen is reflexed to an immunoassay for Treponema specific (treponemal
) antibodies, which can serve as confirmation for the positive screen (Figure, A).
pallidum proteins in treponemal
cell membrane is presented in Figure 1.
antibody absorption tests were reactive for IgG and IgM.
Serologic nontreponemal (rapid plasma reagin test) and treponemal
specific tests (fluorescent treponemal
antibody absorption test) were the most commonly used tests, being used in 17 and 21 studies, respectively.