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

2017 ◽  
Vol 32 (3) ◽  
pp. 474-481 ◽  
Author(s):  
S. Zheng ◽  
R.J. Lin ◽  
Y.H. Chan ◽  
C.C.L. Ngan
Keyword(s):  
Cerebrospinal Fluid ◽  
Laboratory Test ◽  
False Positive ◽  
Research Laboratory ◽  
Case Control Study ◽  
Venereal Disease ◽  
Case Control ◽  
Venereal Disease Research Laboratory ◽  
Disease Research ◽  
Control Study

scholarly journals False positive venereal disease research laboratory of cerebrospinal fluid

2015 ◽  
Vol 48 (2) ◽  
pp. S130 ◽  
Author(s):  
Yu-Jung Tung ◽  
Min-ham Hsieh ◽  
Chun-Yu Lin ◽  
Yen-Hsu Chen ◽  
Chung-Hao Huang
Keyword(s):  
Cerebrospinal Fluid ◽  
False Positive ◽  
Research Laboratory ◽  
Venereal Disease ◽  
Venereal Disease Research Laboratory ◽  
Disease Research

scholarly journals 339. Assessing Utilization of the Venereal Disease Research Laboratory Test in Cerebrospinal Fluid for the Diagnosis of Neurosyphilis: A Cohort Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S239-S240
Author(s):  
Terin Sytsma ◽  
Elitza Theel ◽  
Zelalem Temesgan ◽  
Michel Toledano
Keyword(s):  
Cerebrospinal Fluid ◽  
Cohort Study ◽  
Clinical Practice ◽  
False Positive ◽  
Research Laboratory ◽  
Venereal Disease ◽  
Venereal Disease Research Laboratory ◽  
Inappropriate Use ◽  
Disease Research ◽  
False Positivity

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

Biological false-positive tests comprise a high proportion of Venereal Disease Research Laboratory reactions in an analysis of 300,000 sera

2005 ◽  
Vol 16 (11) ◽  
pp. 722-726 ◽  
Author(s):  
Alexandra Geusau ◽  
Harald Kittler ◽  
Ulrike Hein ◽  
Edda Dangl-Erlach ◽  
Georg Stingl ◽  
...  
Keyword(s):  
Retrospective Study ◽  
False Positive ◽  
Research Laboratory ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Transmitted Infection ◽  
Specific Test ◽  
Disease Research ◽  
Syphilis Screening

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.

Issues in Cerebrospinal Fluid Management: CSF Venereal Disease Research Laboratory Testing

1991 ◽  
Vol 95 (3) ◽  
pp. 397-401 ◽  
Author(s):  
Robert E. Albright ◽  
Robert H. Christenson ◽  
James L. Emlet ◽  
C. Blease Graham ◽  
Enrique G. Estevez ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Laboratory Testing ◽  
Research Laboratory ◽  
Venereal Disease ◽  
Fluid Management ◽  
Venereal Disease Research Laboratory ◽  
Disease Research
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