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The Venereal Disease Research Laboratory test (VDRL) is a blood test for syphilis and related non-venereal treponematoses that was developed by the eponymous US laboratory. The VDRL test is used to screen for syphilis (it has high sensitivity ), whereas other, more specific tests are used to diagnose the disease.
Replacement tests such as the VDRL test and the RPR test, initially based on flocculation techniques (Hinton), have been shown to produce far fewer false positive results. [citation needed] Indeed, the "biologic false positives" of modern tests usually indicate a serious alternate condition, often an autoimmune disease.
Centers for Disease Control and Prevention (CDC)-approved standard tests include the VDRL test (a slide test), the rapid plasma reagin (RPR) test (a card test), the unheated serum reagin (USR) test, and the toluidine red unheated serum test (TRUST). [2] These have mostly replaced the first nontreponemal test, the Wassermann test. [citation needed]
The fluorescent treponemal antibody absorption (FTA-ABS) test is a diagnostic test for syphilis.Using antibodies specific for the Treponema pallidum species, such tests would be assumed to be more specific than non-treponemal testing such as VDRL but have been shown repeatedly to be sensitive but not specific for the diagnosis of neurosyphilis in cerebrospinal fluid (CSF).
The VDRL test of the CSF is a common test for making a diagnosis of neurosyphilis. A positive VDRL test in the presence of neurological symptoms is sufficient to confirm a diagnosis of neurosyphilis. [4] However, a negative VDRL result does not rule out neurosyphilis.
Treponemal antibody tests usually become positive two to five weeks after the initial infection [22] and remain positive for many years. [43] Neurosyphilis is diagnosed by finding high numbers of leukocytes (predominately lymphocytes) and high protein levels in the cerebrospinal fluid in the setting of a known syphilis infection. [3] [19]
It is one of several nontreponemal tests for syphilis (along with the Wassermann test and the VDRL test). The term reagin means that this test does not look for antibodies against the bacterium itself, Treponema pallidum, but rather for antibodies against substances released by cells when they are damaged by T. pallidum (cardiolipin and lecithin).
Fig. 1: Microwells showing positive and negative TPHA test. The Treponema pallidum particle agglutination assay (also called TPPA test) is an indirect agglutination assay used for detection and titration of antibodies against the causative agent of syphilis, Treponema pallidum subspecies pallidum. It also detects other treponematoses. [citation ...