Dr. Goswami Parth Rajendragiri
Pathology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Actually my friend's wife while checking the VDRL test in the first trimester got a positive result, but her husband got negative at the same time, and the doctor told her to do the RPR test then it is negative. What it means? I have a doubt weather she is positive or negative? Please clear my doubt.
Hello,
Welcome to icliniq.com.
The VDRL (venereal disease research laboratory test) and RPR (rapid plasma reagin) are a screening tests for syphilis. Some nonspecific antibodies sometime might give false-positive results. Your RPR, however, is negative. So syphilis is less likely. But you cannot rely on these two screening tests. You can investigate her with a more advanced confirmatory test like FTA ABS (fluorescent treponemal antibody absorption) or TPHA (treponema pallidum hemagglutination) test for syphilis. I hope this helps.
Patient's Query
Thank you doctor,
My actual question is, her husband got negative in HIV and HBs and also in VRDL, and she is negative in HIV and HBs tests, but how can she got positive in VRDL and got negative in RPr? Can you explain this in detail? We sent her blood samples for the TEEP test and waiting for the results. What will be the result? Her husband is a little panic about the result.
Hello,
Welcome back to icliniq.com.
I can understand his anxiety level. The VDRL is a antibody screening test. Hence sometimes it can be positive although syphilis is actually not present in patient. The pregnancy, some viral infection, lupus, etc., can give such a false result. The RPR also is a screening test. The meaning of screening test is if it comes positive then you need to confirm by some other confirmatory tests as I have mentioned. So let us wait for the confirmatory test. You can discuss with a dermatologist for detailed evaluation if needed. Hope I have answered your question Let me know if I can assist you further Regards
Patient's Query
Thank you doctor,
If she is non-reactive in the TEHP test, then shall we can assume that she got a false positive in VRDL for lupus disease and nothing to worry about the result? Or else she has to do further tests for why she got false-positive result? Please explain.
Hello,
Welcome back to icliniq.com.
The VDRL and RPR are screening tests. They are non-treponemal antibody detecting tests, which means they do not detect specific antibody against syphilis. While TPHA and FTA ABS detect treponemal antibody testing and so considered as confirmatory tests for syphilis. Syphilis spread through blood and by sexual route as well. If the confirmatory test is negative then no need to worry. So, I prefer the above mentioned two tests for further work up. If there are any other specific clinical symptoms, then other investigations can be planned, but it is not needed now as per her history. Do investigate the confirmatory test for syphilis. These confirmatory tests give reliable results in two to five weeks after exposure. I hope I have answered your question.
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Pathology
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