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[CSF diagnosis in syphilis].

D Doese, H Heise, K H Rätz

    Zeitschrift Fur Hautkrankheiten
    |January 15, 1984
    PubMed
    Summary
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    Treponema pallidum antibodies in cerebrospinal fluid (CSF) can be detected long after treatment. The TPHA-index and CSF barrier checks aid in diagnosing neurosyphilis.

    Area of Science:

    • Neurology
    • Infectious Diseases
    • Immunology

    Context:

    • Neurosyphilis diagnosis can be challenging, even with the presence of treponemal antibodies in cerebrospinal fluid (CSF).
    • Standard tests like FTA-ABS and TPHA can detect antibodies, but differentiating active neurosyphilis requires further assessment.
    • The integrity of the CSF barrier and specific antibody indices are crucial for accurate diagnosis.

    Purpose:

    • To evaluate the utility of treponemal antibody tests in CSF for diagnosing neurosyphilis.
    • To assess the long-term presence of antibodies after syphilis treatment.
    • To determine the diagnostic value of the TPHA-index and CSF barrier function in identifying active neurosyphilis.

    Summary:

    • Treponemal antibodies, detected by FTA-ABS and TPHA, are frequently found in CSF, even in non-neurosyphilis cases.

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  • Antibodies against Treponema pallidum were identified in 15 patients up to 30 years post-treatment, albeit at low titers.
  • Active neurosyphilis was confirmed in only one case using TPHA- and IgG-indices, highlighting the importance of combined diagnostic markers.

    • Impact:

    • This study underscores the need for careful interpretation of treponemal antibodies in CSF.
    • The findings emphasize the diagnostic role of the TPHA-index and CSF barrier assessment in neurosyphilis.
    • It provides insights into the long-term serological follow-up of syphilis patients, aiding in the detection of late-stage neurosyphilis.