Serological reaction for the diagnosis of syphilis. Laboratory diagnosis of syphilis. Positive seroreactions in the absence of symptoms of syphilis

Reagin tests are used for mass screening of patients for syphilis. They are usually carried out as part of preventive examinations. Such tests are available in every medical facility and are carried out quickly. The answer is usually ready after 30-40 minutes.

A positive result during reagin reactions is not a criterion for making a diagnosis. Additional species-specific studies are needed.

The most common screening method is the Wasserman reaction. It uses cardiolipin and treponemal antigens. If there are no reagins in the blood serum, then hemolysis of ram erythrocytes will occur, which are added as an indicator.

In the presence of reagins, whole erythrocytes will precipitate, in which case the reaction is considered positive.

Reaginic in the following cases:

other diseases, the causative agents of which are similar in antigenic structure to pallidum spirochete
pregnancy
oncological diseases
taking salicylates
myocardial infarction
technical errors in the analysis

With a positive result of the reaginic reaction, specific serological tests are performed. They are also prescribed if a negative result is in doubt.

Treponemal antigens are used in such assays as RIF, RIT, ELISA, TPHA, hemadsorption reaction in the solid phase. These reactions are based on the formation of antigen-antibody complexes and differ in the method of their determination. The most commonly used reaction is immunofluorescence.

The drug is treated with luminescent serum, which allows you to determine the immune complexes under a fluorescent microscope.

One of the most sensitive serological tests for diagnosing syphilis is TPHA. The method has high accuracy. It is often used to verify a pregnancy diagnosis when other tests may be false. positive result.

Features of serodiagnosis

For serological diagnosis of syphilis in its different periods draw blood from a vein. The analysis is recommended to be carried out on an empty stomach, this reduces the number of false positive results. The tube must be sterile. When conducting express tests, in some cases, blood is taken from a finger.

If suspected, cerebrospinal fluid is taken for serodiagnosis. For its analysis, the same methods are used as in the study of blood.

To diagnose syphilis, go through a complete examination in our clinic.

Syphilis is multifaceted. The infection, entering the body, leaves marks not only on the skin and genitals, but also destroys the nervous system, musculoskeletal system, lungs, impairs hearing and vision. Despite a wide range of symptoms and variants of their combinations, doctors have learned to identify the disease and accurately indicate the stage of its development.

Society wants to protect itself from infection with Treponema pallidum. Therefore, a number of express tests are provided for the early diagnosis of syphilis or the identification of carriers of the infection. The rule was blood sampling for laboratory diagnostics:

in cases of pregnancy;
before the operation;
from donors before donating blood or organs for transplantation;
medical workers, teachers, educators, workers in the field Catering and etc.;
military personnel;
at the prisoners.

Laboratory test and clinical examination for syphilis will be carried out for:

patients with signs of STDs;
sexual partners and other family members of a person diagnosed with syphilis;
babies born from a sick mother;
anyone diagnosed with another sexually transmitted disease;
testing the effectiveness of the therapeutic method during treatment;
everyone who has tested positive.

The procedure for detecting infection at a venereologist's appointment

From a conversation with a patient, the doctor finds out:

whether the partner has a confirmed diagnosis of syphilis;
whether there have been rashes on the genitals before;
Are the lymph nodes inflamed?
whether there was unprotected sex 3-4 weeks ago.

During a clinical examination of the skin, genitals, anus, mucous membranes, the specialist finds out the similarity of rashes and other skin lesions with those characteristic of syphilis. Peripheral lymph nodes are carefully palpated to assess the degree of their enlargement.

In cases of syphilides (hard chancre, roseol, papules, granulomas), the doctor prescribes a histomorphological examination. The laboratory describes appearance and study the content of education. Based on the results, the stage of the disease is judged.

A decisive contribution to the diagnosis of syphilis is made by the laboratory method of identifying the pathogen or traces of the immune response to infection.

The diagnosis is established on the basis of a combination of data obtained after a clinical examination and laboratory tests. In exceptional cases, when it is impossible to conduct tests, treatment is prescribed on the basis of an examination.

Diagnosis of complications

Secondary and tertiary syphilis can produce complications called specific visceritis. All organs and systems can be included in the process, but most often venereologists observe lesions:

liver;
nervous system;
bones;
hearts.

Syphilis is especially dangerous for pregnant women. In addition to complicated pregnancy, intrauterine or vertical (in the birth canal) infection of the fetus, stillbirth is not excluded.

It is important to diagnose not only the infection, but also secondary diseases in time. For this purpose, in addition to specific tests and general urine and blood tests, additional examinations are carried out (Table).

Laboratory analyzes of biological materials

Laboratory diagnosis of syphilis began to develop since 1905, when the causative agent of the disease, pale treponema, was discovered. Prior to this, rabbits were infected with the contents of syphilides, which are 100% susceptible to infection. Already in 1906, Wasserman developed the first serological test for syphilis (RW). In 1949, medicine proposed a more specific treponema pallidum immobilization test (TPT), but RW has not been ousted from laboratories until today.

The first analyzes are being replaced modern methods diagnostics. They differ in technique and purpose. In the list of current tests:

dark-field microscopy - involves the study of a smear or scraping to detect treponema in the substrate under study (in everyday life, this study is sometimes called a "smear for syphilis");
molecular biological methods for detecting specific DNA (polymerase chain reaction, DNA probing);
serological diagnosis of syphilis in blood serum or cerebrospinal fluid.

Dark field microscopy

Samples are taken from the lesions for microscopic examination for pale treponema. The objects of testing are:

contents of syphilis;
tissue fluid;
liquor;
amniotic fluid;
cord tissue.

Treponema has received the characteristic "pale" due to its resistance to the action of most dyes. A living microbe is clearly visible in dark field with special lighting. The laboratory assistant draws attention to morphological features bacteria and observes the nature of their movement.

For histomorphological examination, samples are stained with silver (according to Morozov) or according to Romanovsky-Giemsa.

Direct microscopy methods are used to diagnose congenital disease or advanced stages of syphilis. You can check its correctness by direct immunofluorescence reaction (RIF-Tr) or polymerase chain reaction (PCR). In the first case, anti-treponemal antibodies and a fluorescent dye help to identify the pathogen, and in the second case, DNA molecules of pale treponema.

Search for pathogen DNA

Even a single treponema DNA molecule can be detected in a blood test. Advances in this field have been made possible since 1991, when the polymerase chain reaction (PCR) test was invented. The carrier of hereditary information is propagated in special temperature conditions and replicated many times by an enzyme called DNA polymerase. After, by electrophoresis, the desired fragments of the chain are revealed.

This is a very accurate and specific test. Abroad, it has become the gold standard for diagnosing syphilis. In Russia, PCR is still more research than clinical.

Another way to detect treponema during DNA probing (hybridization of nucleic acids). In this case, the denatured DNA is connected to a specific probe. A change in the color of the filter on which the samples are applied indicates contamination.

Serological diagnostic methods

Serological non-treponemal and treponemal tests can be used for various diagnostic purposes. During the analysis, antibodies to pale treponema in the blood are detected.

As an express diagnostic or screening, it is recommended to refer to the following non-treponemal tests:

RPR - Rapid Plasma Reagins test;
RST, Reagin Screen Test;
TRUST - test with toluidine red and unheated serum (Toluidin Red Unheated Serum Test);
USR - test for the determination of active plasma reagins (Unheated Serum Reagins);
VDRL – Venereal Disease Research Laboratory;
precipitation microreactions (MRP) with plasma or inactivated serum;
complement fixation reaction (RSK) and its variants with cardiolipin antigen (RSKk).

The method is based on the search for antibodies (IgM and IgG) to the lipids of damaged cells and lipoproteins of pathogen membranes. The above tests show a positive answer already a week after the appearance of the first syphilides.

Antibodies to treponema itself are detected by methods:

ELISA - enzyme immunoassay - ELISA (Enzymelynked immunosorbent assay);
FTA - immunofluorescence reactions - RIF (Fluorescent treponemal antibody);
RW - complement fixation reactions (Wassermann reaction);
RW with treponemal antigen - RSKt;
TPHA - reactions of passive hemagglutination - TPHA (Treponema pallidum haemagglutination assay);
TPI - reactions of immobilization of pale treponema - RIBT or RIT (Treponema pallidum immobilization test);
Western Blot - immunoblotting.

Venereologists follow a specific procedure for conducting serological tests. As an express diagnostic, one of the non-treponemal tests is performed. Low sensitivity in the early and late stages of infection is taken into account. Therefore, both negative and positive responses with a certain clinical picture should be rechecked by treponemal methods.

In different life situations, combinations of positive and negative answers can be observed. The table will help decipher them.

The final conclusions are made by the venereologist on the basis of a set of data: the clinical picture, histological and laboratory studies.

Sources:

Akovbyan V.A., Prokhorenkov V.I., Novikov A.I., Guzey T.N. // Syphilis: illustration. hands-in (ed. V.I. Prokhorenkov). - M.: Medkniga, 2002. - S. 194-201.
Dmitriev G.A., Frigo N.V. // Syphilis. Differential clinical and laboratory diagnosis. – M.: Med. book, 2004. - S. 26-45.
Loseva O.K., Lovenetsky A.N. Epidemiology, clinic, diagnosis and treatment of syphilis: a guide for doctors. - M., 2000.
Pankratov V.G., Pankratov O.V., Navrotsky A.L. etc. // Recipe (Appendix: International Scientific and Practical Conf. “ Modern approaches to the diagnosis, treatment and prevention of sexually transmitted infections, Grodno, 2005). - 2005. - S. 165-169.
Pankratov V.G., Pankratov O.V. // Modern possibilities of laboratory diagnostics of syphilis and interpretation of research results. – Minsk, Belarusian Medical Academy of Postgraduate Education, 2006.
Pankratov V.G., Pankratov O.V., Krukovich A.A. etc. // Healthcare. - 2006. - No. 6. - P. 35-39.
Rodionov A.N. // Syphilis: a guide for doctors. - St. Petersburg: Peter, 1997. - S. 226-245.
Jurado R.L. // STD. - 1997. - No. 3. - S. 3-10.
Schmidt B.L. // First Russian Congress of Dermatovenerologists: abstract. scientific works. - St. Petersburg, 2003. - T. II. - S. 40-41.
Romanowski B., Sutherland R., Flick G.H. et al. // Ann. Med. –1991. - V. 114. - P. 1005-1009.

The site provides background information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Diagnostics syphilis often presents difficulties. The greatest difficulty in diagnosis is chronic forms of syphilis, secondary syphilis, and the latent phase of a syphilitic lesion. However, the detection of this disease should be based on a standard scheme.

Contacting a venereologist - why is it necessary?

At the first stage of diagnosis, a personal consultation with a venereologist is necessary. Based on a personal consultation, a venereologist is able to make a clinical diagnosis.

Anamnesis- collection of information necessary to identify the diagnosis: patient complaints, information about some aspects of sexual life and contacts with suspected sexually transmitted diseases persons. Past sexually transmitted diseases, information about the results of their treatment. All this information allows the attending physician to concentrate on the most likely diseases that caused the patient to seek specialized help.

Followed by clinical examination. The mucous membranes and skin of the genital organs, the anus area, and the oral mucosa are subjected to the most careful examination. Increased attention is paid to palpation of the outer groups of lymph nodes, palpation of identified infectious necrotic foci. Often at this stage, the diagnosis of syphilis can be made with a fairly high degree of probability.

However, in order to make a final diagnosis, as well as to monitor the dynamics of the process during the ongoing treatment, it is necessary to conduct laboratory tests.

Laboratory confirmation of syphilis - what does it include and how is it done?

Laboratory diagnosis of syphilis can be divided into 2 groups of ongoing research: the first allows you to directly identify the causative agent of syphilis, while the second reveals the immunological changes that occur in the body during syphilis.

How can you directly identify the causative agent of syphilis - pale treponema?
1. dark field microscopy. Due to some external features, pale treponema stains poorly with traditional stains used in bacterial microscopy. Therefore, it makes sense to use a special dark-field microscope. In it, against a dark background, a spiral strip is well contrasted - pale treponema.
Biomaterial for dark-field microscopy is taken from the primary focus of infection - from a specific syphilitic ulcer, skin rash, erosion.

2. Direct fluorescence reaction. This diagnostic method is preceded by the processing of the biomaterial with a special fluorescent serum, which leads to the attachment of specific immune complexes on the surface of pale treponema. As a result of this reaction, when microscopy of the processed biomaterial in a fluorescent microscope, pale treponema looks luminous and elegant.

3. PCR ( polymerase chain reaction). This method allows you to identify the DNA of an infectious agent, making its presence in the patient's body clear.

How are immunological signs of syphilis detected, and why should they be detected?
The whole group of studies of immunological parameters for the purpose of diagnosing infectious diseases is called serology. Nowadays, there are many serological diagnostic methods, but all of them are united by the fact that the biomaterial in diagnostics is the patient's blood. With regard to the diagnosis of syphilis, all serological tests can be divided into treponemal - detecting antibodies against the structural elements of pale treponema and non-treponemal - revealing immunological changes associated with the consequences of bacterial activity.

Non-treponemal serology
1. Precipitation microreaction (VDRL). This study detects in the patient's blood antibodies produced by the immune system against cells damaged by pale treponema. This test has high reliability, but low specificity. The fact is that detectable antibodies can be present in the blood in many diseases and pathological conditions. Therefore, this test is used only as a screening for a disease, revealing a suspicion of a disease. However, this method has an invaluable advantage in diagnosing the effectiveness of the treatment. If the patient is cured, the precipitation microreaction with the cardiolipin antigen becomes negative, unlike other serological types of research, which can give a positive result for a long time.

2. Wasserman reaction. This study is associated with the complement fixation reaction - one of the mechanisms for the implementation of the immunological response.
The test is evaluated in pluses ( not in crosses, as many believe!). And the reaction is negative as a result of the survey indicated minus), doubtful ( as a result of the survey, 1 plus + is indicated), weakly positive ( as a result of the examination, 2 pluses are indicated ++), positive reaction ( as a result of the examination, 3 pluses are indicated +++), a sharply positive reaction ( as a result of the examination, 4 pluses are indicated ++++).

Treponemal serology
1. Immunofluorescence reaction (RIF). This type research detects antibodies produced by the infected person's immune system. For this, the interaction of the patient's blood serum and a specific preparation containing antibodies is performed. After mixing the patient's blood plasma and the reagent with specific antibodies labeled with a special fluorescent substance, they are bound. The study is carried out using a special fluorescent microscope.

2. Enzyme immunoassay (ELISA). This analysis deserves more details. Since it is the main one in identifying most infectious diseases. The method is based on a selective highly specific antigen-antibody reaction. One of the features of this analysis is that it can be used to detect antibodies of various classes ( IgA IgM IgG ) . Also important is the ability of this analysis to determine the amount of antibodies detected. As a result, the determination of the type of antibodies and its quantitative component allows us to draw a number of conclusions about the duration of the disease, the dynamics of the process, the activity of the pathogen and the patient's immune system. As a result, this analysis turned out to be indispensable in diagnosing infectious diseases, as well as monitoring the dynamics of the disease against the background of ongoing treatment.

3. The reaction of passive hemagglutination (RPHA). This reaction is based on immunologically induced agglutination of erythrocytes. The mechanism of this reaction is that erythrocytes are preliminarily prepared, on the surface of which the protein components of pale treponema are fixed. Therefore, when mixed with blood plasma containing antibodies to treponema, erythrocytes stick together - the blood turns from red to granular. A positive hemagglutination reaction becomes 4 weeks after infection. After successful treatment of syphilis, this reaction can remain positive throughout life.

From the foregoing, it is clear that the matter of diagnosing, monitoring the effectiveness of treatment and cure is a rather complicated and time-consuming work. And it is impossible for a patient who does not have a medical education to understand the goals and results of the study. However, we will try to present in an accessible form the dynamics of immunological changes at different stages of syphilis, and laboratory indicators that reveal these changes.

So - a little theory. After infection, immune cells first encounter treponema pallidum. Identifying it as a foreign microorganism, immunocompetent cells begin the active formation of an immune response. Antibodies specific to treponema pallidum IgM, are found in the patient's blood 7 days after infection, antibodies IgG synthesized later - after 4 weeks. These 2 classes of antibodies are different in structure, but it is important for diagnosis that IgM synthesized on early stages infections ( What does it mean for a recent infection?) or in the presence of high infection activity. The detection of IgG only indicates the formation of stable immunity to this infection, only a series of analyzes of the antibody titer in dynamics allows us to assess the cure of the disease or the activity of the infection. Antilipid ( non-specific) immunological complexes are actively synthesized 4-5 weeks after infection.
Important is the fact that during the period of clinical manifestations of syphilis in the blood, antibodies specific for pale treponema are detected as IgM, and the class IgG (total antibodies). An important parameter in the treatment process is the change in the quantitative parameters of antibodies. Properly selected treatment contributes to a sharp decrease in concentration IgM, against the background of a stable level IgG- these indicators indicate the formed stable immunity to pale treponema against the background of a decrease in its infectious activity. It is necessary to pay attention to the fact that specific antibodies to treponema can remain in human blood for many years, giving positive results in some types of studies.

How to interpret the results of serological studies?

Currently in medical practice 3 reactions are widely used: precipitation microreaction, immunofluorescence reaction (RIF), passive hemagglutination reaction (RPHA).

precipitation microreaction	immunofluorescence reaction (RIF)	passive hemagglutination reaction (RPHA)	Interpretation
-	-	-	No infection or diagnosis too early ( up to 7 days after infection)
+	+	+	Confirmation of syphilis
-	+	+	Condition after treatment of syphilis or advanced stage of syphilis
+	-	+	There is a high probability of false positive or false negative results ( it is recommended to repeat the serological diagnosis)
-	-	+	There is a high probability of a false-positive reaction of RPHA, or a condition after adequate treatment of syphilis
-	+	-	Evidence of early syphilis or post-treatment condition, false-positive RIF reaction
+	-	-	False positive microprecipitation reaction

From the above table with the results of the main serological tests, it can be seen that the diagnosis of syphilis cannot be based on serological tests alone. In addition to blood tests, a complex is needed to make a final diagnosis. clinical research: history, personal examination of the affected areas, identification of suspicious contacts.

Diagnosis of syphilis includes:

The study of the anamnesis of life and disease.
Clinical examination of the patient.
Examination of the material from the affected areas (lymph nodes, cerebrospinal fluid, amniotic fluid) for the detection of pale treponema.
Conducting serodiagnostics (non-treponemal and treponemal tests).
Conducting additional laboratory tests (general blood and urine tests, blood biochemistry, etc.).

Non-treponemal tests can detect antibodies to phospholipids in the blood serum, which are destroyed due to this disease.

Non-treponemal tests include:

Anticardiolipin test (rapid plasma reagin test, RPR, rapid test for syphilis).
Complement fixation reaction with cardiolipin antigen (Wassermann reaction).
microscopic test.

The Wasserman reaction can also be carried out with treponemal antigen. Therefore, depending on what material is used in the reaction, this study can be attributed to both treponemal and non-treponemal.

Description and principle of action of the anticardiolipin test (RPR).

The causative agent of syphilis is Treponema palidum. This pathogen has several antigens alien to the human body, which are similar in structure to cardiolipin. The patient's immune system reacts to cardiolipin antigens by producing specific antibodies of the IgG and IgM classes.

This rapid test for syphilis is non-treponemal. The study allows to detect antiphospholipid antibodies in the blood of patients with primary syphilis in 75% of cases. At the stage of secondary syphilis, the test result is positive in 100% of the examined. The most effective test is considered to be a week after the formation of a syphilitic ulcer or 3-5 weeks after infection.

Carrying out this diagnostic method is relevant for screening during pregnancy and for examining a sexual partner. Also, the test is used to evaluate the effectiveness of the prescribed treatment. After adequate therapy, the result of the anticardiolipin test becomes negative.

Due to the fact that the test belongs to a number of non-specific, it is possible to develop a false positive result. This is due to the fact that these antibodies can be detected in a number of other infections caused by pale treponema.

Provided that the result of this diagnostic method showed positive results, it is recommended to consult a doctor (dermatovenereologist) and re-examine using a specific treponemal test.

The study should be carried out on an empty stomach. The patient is informed that it is contraindicated to eat food for 8 hours before the analysis. You can drink a glass of water in the morning.

note

To date, it is possible to take tests for syphilis in medical institutions, both public and private. Tests for syphilis in any type of laboratory must be conducted anonymously.

For an express test for syphilis, an antigen is used, which includes cardiolipin, lecithin and cholesterol, as well as the patient's blood. For better visualization of the research result, coal particles are used. With a positive result, black flocculants are formed in the whey.

With a titer of 1:2 to 1:320 and above, the result of an express test to confirm the diagnosis of syphilis is considered positive.

The result is considered negative in the absence of antibodies. Doubtful reaction - low titers of antibodies.

You can also buy a syphilis test kit at the pharmacy to use at home.

RPGA blood test: preparation for delivery and analysis of the results

More reliable tests for diagnosing a disease are considered to be studies that can detect specific antigens of the causative agent of the disease or antigen-antibody complexes.

These treponemal tests include:

Immunofluorescence reaction (RIF).
Passive agglutination reaction (RPHA).
Enzyme immunoassay (ELISA).
Treponema palidum immobilization reaction.
Immunobloding.

What is a RPHA blood test?

With the help of this study, it is possible to identify the agglutination of those erythrocytes on the surface of which the antigens of the causative agent of syphilis were fixed. The analysis should be carried out in conjunction with the rapid plasma reagin test.

This is due to the fact that with a single blood test for syphilis using the RPGA method, it is possible to develop a negative result of the study in the first 4 weeks after infection, with primary syphilis and with a latent course of the disease.

Preparing the patient for the test:

The study is shown to be carried out on an empty stomach.
You should limit fluid intake (in the evening and in the morning you can drink a glass of plain water).
It is recommended to take the analysis in the first half of the day.
For 30 minutes it is strictly contraindicated to smoke.
The content of alcohol in the blood is unacceptable.

If all of the above recommendations are not followed, the risk of developing false positive results increases.

Today, this research method is gradually being replaced by more modern and highly sensitive ones (rapid methods, RPGA, etc.). But, nevertheless, in the CIS countries it is still used as a screening study.

Deciphering blood test data on RW:

"-" - the result is negative.
"+/-" - doubtful.
"++" - weakly positive.
"+++" - positive.
"++++" - sharply positive.

In the case of a sharply positive result of the study, the titer ranges from 1:2 to 1:800.

This test was proposed by the German immunologist A. Wasserman, and it was named after him - the Wasserman reaction, or RW. Its main advantages are cheapness, simplicity, quick results.

Blood is donated for EDS during screenings, that is, mass examinations, to determine diseases in healthy, at first glance, people who do not have any alarming symptoms. Currently, such a test is considered obsolete and is being replaced by others, but until now, when it comes to non-treponemal detection of syphilis, the expression “donate blood for RW” is used.

Description of the EMF blood test and its purpose

A blood test for EMF is given not only by those patients who suspect that they have a disease, or intend to confirm an already diagnosed diagnosis, but also without fail by blood donors and pregnant women. Syphilis therapy can be carried out through the use of antibiotics, but an untreated disease develops into a chronic form that affects all organs of the human body, and is also characterized by constant remissions and relapses.

The test is carried out in the following cases:

If there is a suspicion of syphilis.
To confirm the diagnosis - latent syphilis.
If necessary, verification of donors.
Pregnancy tests.
Screening.

How long does a blood test for EMF take? This test is very fast. After half an hour, you can analyze the result.

carrier

A sick patient and his body fluids act as a carrier of syphilis. Infection is possible through sexual contact, through the blood or through the use of personal hygiene items. Usually the cause of the disease is promiscuity. The sooner the pathology is diagnosed, the faster and easier the treatment becomes. To pass the test, you can simply donate blood on an empty stomach. If no other tests are required, except for the EMF, then you just need not to use food products within eight hours. The day before the analysis, you do not need to follow a special diet. Usually blood is taken from a vein, but it is also possible from a finger, since a large amount of it is not needed. What is an EMF (blood test)? Let's consider in more detail.

If antibodies are found

When antibodies are detected, it is possible to judge the penetration of the infection into the human body to a certain extent. The cardiolipin involved in the test is a substance that is extracted from a bovine heart. A special cardiolipin solution is combined with a small amount of blood in glass wells. The resulting solution is evaluated after half an hour on the amount of the resulting precipitate.

Be aware of possible errors. A positive result does not always mean that the patient is sick. Although the test is quite effective, it still needs to be confirmed by other tests, so blood must be taken several times. This is especially true for pregnant women. In addition to determining the diagnosis, this test makes it possible to identify the stage of the disease from the first to the fourth. Treatment is prescribed based on the information received.

Not everyone knows that this is a blood test for EMF.

Deciphering the analysis for syphilis and normal indicators

During the EMF procedure, it is difficult to talk about a certain norm or its violations. The result in this case is either negative or positive. But besides this, there are also titers that show how much antibodies are present in the blood. Each specific result should be deciphered by a specialist. There are a large number of different subtleties, and therefore there is no need to draw premature conclusions and try to decipher the analysis on your own or find the answer to the question of what it is - a blood test for EMF - using the Internet.

Cell class lgM or lgG

The class affiliation of lgM or lgG cells is indicated: when treponema enters the body, the immune system begins to react violently to the penetration of foreign cells. First, antibodies such as lgM are formed. They can be detected as early as a week after a person has become infected. lgG, on the other hand, appear in the body after about a month and are able to remain in it for a long period, even if the disease has been successfully cured. Presence this class may serve as an indication that the body has developed a stable immune response to pale treponema.

With a negative result and the credits indicated at the same time with the word lgG next to them, one can judge the secondary nature of syphilis. That is, there are antibodies to pale treponema in the blood, but these are memory antibodies that can circulate in the body for a long time after the patient has recovered. Such an analysis in some cases may be positive, although in fact it is a false positive. An accurate determination requires taking into account all previous research results and monitoring the decrease in titer. All subsequent tests may continue to give a positive result.

The interpretation of a blood test for EMF should be carried out by a highly qualified specialist.

How to determine the degree of damage?

It can give both positive and negative results. The defeat is more serious than large quantity there are pluses in the indicators.

weakly positive reaction - + and ++ (if plus one, then the result is doubtful);
positive - +++;
sharply positive - ++++.

According to the results of the analysis, antibody titers are indicated. When conducting a study to monitor therapy, titers allow you to determine whether the patient is recovering. As a rule, the patient after treatment is under the supervision of specialists throughout the year. During this period, he is tested several times. The effectiveness of therapy is also evidenced by a decrease in titers per year by four or more times. In the absence of IgM immunoglobulins in the blood, one can speak of the absence of a resumption of infection. The presence of IgG is possible for a long time after treatment, and sometimes even for life.

What is this? It must be remembered that this method has certain disadvantages. The study is appointed in order to confirm suspicions, however, it is far from possible to count on a reliable result in all cases.

The Wasserman reaction can have positive indicators not only for syphilis, but also for malaria, lupus, and tuberculosis. Unfortunately, a more efficient and accurate method is still missing. Often, such an analysis is carried out simultaneously with the rest for a more complete picture. In pregnant women, the result may be positive even in the absence of any pathologies. It can also become false during menstruation. How much is a blood test for EMF, it is better to know in advance.

Recheck test

When a positive result is obtained, it is necessary to double-check it several times. The patient has the right to take other tests and require confirmation, since the EMF is not 100% reliable. If ulcers, chancres appear, while they do not hurt and do not bleed, it can be judged that an infection has occurred. You need to contact a specialist right away. The patient must learn all the details of therapy, the action and composition of the prescribed drugs.

During pregnancy, preventive treatment is possible, and it does not need to be abandoned. If a woman was treated for syphilis before pregnancy (or in its early stages), the doctor may prescribe a preventive medication course. The patient also has the right to demand absolute anonymity. The doctor cannot talk about diagnoses and therapy.

There is no need to delay treatment because early stages it happens faster. It is necessary to give up fatty and heavy foods, alcohol and everything that can complicate the healing process.

We examined the EMF - a blood test. What it is is now clear.

Rapid test for syphilis: advantages of diagnosis, indications, how to prepare and indications for conducting

Syphilis is a rather dangerous pathology, the occurrence of which is provoked by the penetration of pale treponema (Treponema pallidum) into the body. The disease is dangerous and with untimely therapy or ignoring the manifestations, it is fraught with critical consequences, including death.

Therapy of a sexually transmitted disease is long and laborious. Timely detection of the disease and appropriate treatment is the best way to prevent the development of complications, improve general condition and well-being. The prognosis will be favorable only if syphilis is detected in the early stages.

Pathology is insidious, characterized by a slow and progressive course. It is often discovered by chance during an examination when another illness is suspected, and therefore it is often detected late.

Late stages of the disease are fraught with irreversible and severe damage not only to internal organs and systems, but also to the central nervous system. A person may not even be aware of the presence of the disease for a long period and infect partners. The risk of infection during intimacy with an infected person is 30-35%. The duration of the latent course is approximately 1.5 months. The symptoms of the disease are varied and change with the progression of the pathology.

When the first alarming symptoms appear - a hard chancre on the skin, it is necessary to immediately seek the help of a specialist and undergo an examination.

You should not try to cure the disease on your own, it is fraught with unpredictable consequences and more often leads to the development of complications. Today, there are many drugs for the treatment of the disease, as well as methods for determining the presence of treponema in the body. Diagnosis of pathology consists in studying the history of life, examining the patient, collecting analyzes (biological material) and further examining fluids, including blood, conducting serodiagnosis. Additional laboratory tests of urine, blood and blood biochemistry are also carried out.

The most popular and very effective method- rapid test for syphilis. The test is similar in principle to a pregnancy test. The only difference is that blood is used instead of urine.

Advantages of the research method

The method for detecting syphilis and its pathogen is in demand and, unlike other methods, has a number of advantages.

The main ones include:

Fast result. Almost any express test for syphilis gives a result within half an hour. In some cases, you will have to wait several hours for the result, but it is still faster than examining the material in laboratories.
Price. The device costs an average of 300 rubles, which is several times cheaper than diagnostics in a laboratory.
The ability to purchase, both in any pharmacy and online store (anonymously).
Possibility of carrying out independently, at home.
Simplicity and accessibility. To pass the test, you do not need special knowledge and skills. All you need to do is read the summary and follow all the recommendations when passing the test.
Anonymity. For the study, there is no need to visit a medical institution. You don't need to leave contact information.

Indications

Anyone can do research.

But most often, an express test for syphilis is recommended:

during gestation;
in case of anxiety symptoms;
in the absence of the possibility of diagnosing in a medical institution;
people who often change sexual partners;
those who suffer from other sexually transmitted infections;
before donating blood (donation);
with close household contact with an infected person;
people who for some reason do not use contraceptive methods;
if there was unprotected sexual contact.

The preparatory stage and the order of the study

In order to obtain a reliable result, a rapid test for syphilis should be carried out taking into account several rules.

It is strictly not recommended to drink alcohol one or two days before the study.
Stop smoking thirty minutes before the test.
The test should be done on an empty stomach and preferably before lunch.
Before carrying out, you must carefully study the instructions.

Failure to follow these recommendations is fraught with a distortion of the result. The test is carried out very simply. No special skills or abilities are required. First, wash your hands well (preferably with soap that has antibacterial properties). You can not carry out the procedure if the test was just purchased, and it has not yet warmed up to room temperature (in winter, for example). The packaging should only be opened after completion of preparation.

So that the strip that has already been removed lies on a horizontal and even surface. In addition, it must be clean and dry.

Before examination, the finger is wiped with an alcohol wipe (its inside). After puncturing the upper phalanx with a scarifier, a drop of blood that comes out should be drawn into a pipette and squeezed into the indicator cell. Next, a reagent is added to the cell - a couple of drops. After about a quarter of an hour, you can find out the result. If the result appeared on the indicator later (more than half an hour later), it is not recommended to consider it correct.

Principle of operation

The operation of the test is similar in principle to the pregnancy test. Only blood is used instead of urine. The result will depend on the type of device and the correctness of the procedure.

RPHA blood test: types and effectiveness of tests, reliability of the result and cost

There are several types of tests. They can be treponemal or non-treponemal. The former are very specific, so screening healthy people happens carefully. Their only drawback is reduced sensitivity in the early stages.

A blood test RPGA (abbreviation stands for passive hemagglutination reaction) is a specific test. The method consists in gluing red blood cells, on the surface of which pathogen antigens accumulate. A similar reaction occurs when the blood of an infected person is added, which contains antibodies to the spirochete.

As for the sensitivity of the blood test RPGA and similar tests, in particular RIF, in the early stages it is about 70-80%, in the later stages - 99%.

A blood test RPHA is far from the only qualitative method that allows you to determine the disease. ELISA is no less effective. With the help of enzyme immunoassay, it is possible to identify the antigen and antibodies to them, the causative agents of a wide variety of infectious diseases. ELISA is both a screening and confirmatory method at the same time. This method helps to identify any sexual infection, as well as syphilis at any stage of its development.

Use of non-treponemal tests

In addition to treponemal tests, in particular, a blood test, RPGA, non-treponemal ones are also isolated. Such devices contribute to the detection in the serum of antibodies to phospholipids that are destroyed due to the disease. Such devices are cheaper than treponemal ones. For their implementation, not an antigen protein (which is specific for treponema), but its alternative (cardiolipin antigen) is used.

Due to the high sensitivity, the test result is often false positive. The use of such tests is recommended for mass screening of the population. If the pathogen is identified, a second check is carried out, but with the use of a treponemal test.

Characteristics of the most effective tests

Today, there are many tests for determining sexually transmitted pathology.

The most accurate and proven include the following types:

Creative MP-syphilis. Highly effective and sensitive test (99%) with the presence of a double combination of antigens. Determines antibodies to the causative agent of syphilis, both in blood, plasma and serum. For the study, a couple of drops of whole blood are used. The result can be found after ten minutes. The presence of treponema in the body will be signaled by the appearance of two pink-purple stripes. If there is only one line in the control area, the person is healthy.
Cito Test Syphilis. This test is immunochromatographic. Equipped with test cassette, buffer, pipette. Everything else needs to be purchased. About ten minutes after the analysis, you can find out the result. The presence of two clear lines indicates the presence of pathology.
ImmunoChrom - antiTR-Express. Detects antibodies to the causative agent of syphilis. The result can be found after a quarter of an hour. Infection is signaled by the appearance of two purple stripes. The kit includes: buffer, alcohol wipes, pipette, test strip, scarifier.
Syphilis test. The set of reagents contributes to the determination of antibodies to treponema by the ICA method (immunochromatographic analysis). The presence of two parallel stripes indicates the presence of syphilis. The result can be found in ten minutes.
Profitest. A test with a sensitivity of 99.5%. Includes: test cassette, lancet, pipette, alcohol wipes. The result will be known after a quarter of an hour. The presence of two bands indicates infection.

Often the results of the research are accurate. A false or unreliable result may be due to an incorrect procedure.

Express diagnostics of syphilis

Once upon a time, the Wassermann reaction was considered the most accurate study that determined the presence of treponema in the blood. Now this method is used less and less, because it has been replaced by more modern reactions that are sensitive to the detection of antibodies to treponema in the first weeks of infection. One such effective blood or serum test is the rapid diagnosis of syphilis. The method is effective both for the initial examination in case of suspected venereal disease, and for the detection of the virus in donors or pregnant women, for patients who have undergone treatment and for patients with a latent form of the disease.

In foreign clinics, the express diagnosis of syphilis is called Rapid Plasma Reagin. The abbreviation for the RPR test is even more common. When an organism is infected with treponema, protective antibodies of the IgG and IgM classes are formed in the blood, which are ready to resist the lipoprotein-like material that is formed in the cells and tissues of the body affected by treponema. This test is non-treponemal because it is not aimed at detecting the virus, but at accurately determining the amount of antibodies in the blood. EMF allows you to set the exact duration of the disease.

EMF is a serological test. It can be taken at any clinic. If desired, the patient can undergo an anonymous blood test for syphilis with the issuance of test results without indicating the name. Having passed the tests, it will not be long to wait for the results of the diagnosis. The blood test lasts about half an hour, but the answer is given in hand on the second day.

To test for syphilis, a small amount of blood is taken from a vein. A prerequisite for obtaining the correct answer is that the patient visits the clinic on an empty stomach. To detect antibodies in the rapid diagnosis of syphilis, blood is mixed with a cardiolipin solution. Testing is similar to the precipitation reaction. A reaction takes place on a special glass plate that detects antibodies. As a result, sediment and flakes appear on the glass. According to them, a diagnosis is made, which is expressed in pluses. As in the Wasserman reaction, 4 + indicate the exact presence of treponema and antibodies in the body. However, the method of rapid diagnosis of syphilis can also give false results when the body has antibodies caused by other diseases. To confirm a positive result with a small amount of +, it is also necessary to pass a treponemal test.

Laboratory diagnosis of syphilis

microscopic examination

Puncture of regional lymph nodes

Serological diagnosis

Wasserman reaction (RV)

Usually RV is placed with two or three antigens. The most commonly used are the highly sensitive cardiolipin antigen (bovine heart extract enriched with cholesterol and lecithin) and treponemal antigen (sonicated suspension of anatogenic cultured treponema pallidum). Together with the reagins of the patient's blood serum, these antigens form an immune complex capable of adsorbing and binding complement. For visual determination of the formed complex (reagins + antigen + complement), a hemolytic system is used as an indicator (a mixture of ram erythrocytes with hemolytic serum). If the complement is bound in the 1st phase of the reaction (reagins + antigen + complement), hemolysis does not occur - the erythrocytes precipitate into an easily noticeable precipitate (PB positive). If complement is not bound in phase 1 due to the absence of reagins in the test serum, it will be used by the hemolytic system and hemolysis will occur (PB negative). The degree of severity of hemolysis in the setting of RV is estimated by the pluses: the complete absence of hemolysis ++++ or 4+ (RV sharply positive); barely begun hemolysis +++ or 3+ (PB positive); significant hemolysis ++ or 2+ (PB weakly positive); incomprehensible picture of hemolysis ± (RV doubtful); complete hemolysis - (Wassermann reaction is negative).

In addition to the qualitative assessment of RV, there is a quantitative formulation with various serum dilutions (1:10, 1:20, 1:80, 1:160, 1:320). The titer of reagins is determined by the maximum dilution, which still gives a sharply positive (4+) result. Quantitative formulation of RV is important in the diagnosis of some clinical forms of syphilitic infection, as well as in monitoring the effectiveness of treatment. Currently, the Wasserman reaction is staged with two antigens (cardiolipin and treponemal sounded Reiter strain). As a rule, RV becomes positive at 5-6 weeks after infection in 25-60% of patients, at 7-8 weeks - in 75-96%, at 9-19 weeks - in 100%, although in last years sometimes sooner or later. At the same time, the titer of reagins gradually increases and reaches a maximum value (1:160-1:320 and above) in the event of the appearance of generalized rashes (secondary fresh syphilis). When RV is positive, a diagnosis of primary seropositive syphilis is made.

In secondary fresh and secondary recurrent syphilis, RV is positive in 100% of patients, but negative results may be observed in immunocompromised malnourished patients. Subsequently, the titer of reagins gradually decreases and in secondary recurrent syphilis usually does not exceed 1:80-1:120.

With tertiary syphilis, RV is positive in 65-70% of patients and a low titer of reagins is usually observed (1:20-1:40). In late forms of syphilis (syphilis of the internal organs, nervous system), a positive RV is observed in 50-80% of cases. The reagin titer ranges from 1:5 to 1:320.

With latent syphilis, a positive RV is observed in 100% of patients. The reagin titer is from 1:80 to 1:640, and with late latent syphilis from 1:10 to 1:20. A rapid decrease in the titer of reagins (up to complete negativity) during treatment indicates the effectiveness of the treatment.

The disadvantages of the Wasserman reaction are insufficient sensitivity (negative in the initial stage of primary syphilis). It is also negative in 1/3 of patients, if they were treated with antibiotics in the past, in patients with tertiary active syphilis with lesions of the skin and mucous membranes, osteoarticular apparatus, internal organs, central nervous system, with late congenital syphilis.

Lack of specificity - the Wasserman reaction may be positive in individuals who have not previously had and do not have syphilis. In particular, false-positive (non-specific) RV results are observed in patients who suffer from systemic lupus erythematosus, leprosy, malaria, malignant neoplasms, liver damage, extensive myocardial infarctions and other diseases, and sometimes in completely healthy people.

A short-term false-positive Wasserman reaction is detected in some women before or after childbirth, in people who abuse drugs, after anesthesia, and drinking alcohol. As a rule, false-positive RV is weakly expressed, often with a low titer of reagins (1:5-1:20), positive (3+) or weakly positive (2+). With mass serological examinations, the frequency of false positive results is 0.1-0.15%. To overcome the lack of sensitivity, they use the setting in the cold (Collard reaction) and at the same time it is set with other serological reactions.

Sedimentary reactions of Kahn and Sachs-Vitebsky

The advantage is the speed of receiving a response (in minutes). The results are evaluated by the amount of precipitate and the size of the flakes. The severity is defined as CSR - 4+, 3+, 2+ and negative. It should be noted that false positive results are observed more often than with RV. As a rule, the express method is used for mass examinations for syphilis, during examinations in clinical diagnostic laboratories, somatic departments and hospitals. Based on the results of the express method, the diagnosis of syphilis is prohibited, its use in pregnant women, donors, and also for control after treatment is excluded.

Treponema pallidum immobilization reaction (RIBT)

RIBT is important in the differential diagnosis to distinguish between false-positive serological reactions from reactions due to syphilis. It becomes positive later than RV, RIF, and therefore it is not used for the diagnosis of infectious forms of syphilis, although in the secondary period of syphilis it is positive in% of patients.

In the tertiary period of syphilis with damage to internal organs, the musculoskeletal system, and the nervous system, RIBT is positive in % of cases (RV is often negative).

It must be remembered that RIBT may turn out to be false-positive if treponemocidal drugs (penicillin, tetracycline, macroliths, etc.) are present in the test serum, which cause nonspecific immobilization of pale treponemas. For this purpose, blood for RIBT is examined no earlier than 2 weeks after the end of antibiotics and other drugs.

RIBT, like RIF, is slowly negative during treatment, so it is not used as a control during treatment.

Immunofluorescence reaction (RIF)

The results of the RIF are taken into account by the intensity of the glow of pale treponemas in the preparation (yellow-green glow). In the absence of anti-treponemal antibodies in serum, pale treponemas are not detected. In the presence of antibodies, the glow of pale treponema is detected, the degree of which is expressed in pluses: 0 and 1+ - backlash; from 2+ to 4+ - positive.

RIF refers to group treponemal reactions and is placed in a dilution of the test serum by 10 and 200 times (RIF-10 and RIF-200). RIF-10 is considered more sensitive, but non-specific positive results often fall out than with RIF-200 (it has a higher specificity). As a rule, RIF becomes positive earlier than RV - positive in primary seronegative syphilis in 80% of patients, in 100% in the secondary period of syphilis, always positive in latent syphilis and in % of cases in late forms and congenital syphilis.

The specificity of RIF increases after pre-treatment of the test serum with a sorbent-ultrasonic treponemal antigen that binds group antibodies (RIF - abs).

Indications for staging RIBT and RIF - diagnosis of latent syphilis to confirm the specificity of the complex of lipid reactions in case of suggesting a syphilitic infection based on a positive RV. Positive RIBT and RIF are evidence of latent syphilis. With false-positive RV in various diseases (systemic lupus erythematosus, malignant neoplasms, etc.) and if repeated results of RIBT and RIF are negative, this indicates the nonspecific nature of RV. Suspicion of late syphilitic lesions of the internal organs, musculoskeletal system, nervous system in the presence of negative RV in patients. Suspicion of primary seronegative syphilis, when in patients with repeated studies of discharge from the surface of erosion (ulcer), with puncture from enlarged regional lymph nodes, pale treponema is not detected - in this case, only RIF is set - 10.

When examining persons with a negative RV who had long-term sexual and domestic contacts with patients with syphilis, given the likely possibility of treating them in the recent past with antisyphilitic drugs that caused RV negativity. Enzyme-linked immunosorbent assay (ELISA, ELISA - enzymelinked immunosorbent assay) - the method was developed by E.Engvall et al., S.Avrames (1971). The essence consists in the combination of a syphilitic antigen adsorbed on the surface of a solid-phase carrier with an antibody of the studied blood serum and the detection of a specific antigen-antibody complex using enzyme-labeled anti-species immune blood serum. This allows you to evaluate the results of ELISA visually by the degree of change in the color of the substrate under the action of the enzyme that is part of the conjugate. Unreliable ELISA results may occur as a result of insufficient dilution of the ingredients, violation of temperature and time regimes, inconsistency in the pH of solutions, contamination of laboratory glassware, and improper technique for washing the carrier.

Passive hemagglutination reaction (RPHA)

Blood collection technique for serological reactions

For research on the express method, blood was taken from the fingertip, as is done when it is taken for ESR, but blood is taken by 1 capillary more. The express method can also be performed with blood serum obtained by venipuncture. If there is a need for blood tests in remote laboratories, dry serum can be sent instead of blood (dry drop method). To do this, the next day after taking blood, the serum is separated from the clot and drawn into a sterile syringe in an amount of 1 ml. Then the serum is poured in the form of 2 separate circles onto a strip of thick writing paper (wax paper or cellophane) 6 × 8 cm in size. The surname, initials of the subject and the date of blood sampling are written on the free edge of the paper. Serum paper is protected from direct sun rays and leave at room temperature until the next day. The serum dries up in the form of small circles of a shiny yellowish vitreous film. After that, paper strips with dried serum are rolled up like pharmaceutical powder and sent to the laboratory, indicating the diagnosis and for what purpose it is being studied.

Serological resistance

Pseudo-resistance - after the treatment, despite positive serological reactions, there is no pale treponema in the body. There is no antigen in the body, but the production of antibodies continues, which are fixed when setting up serological reactions.

Serological resistance can develop due to:

inadequate treatment without taking into account the duration and stage of the disease;
insufficient dose and in particular due to the failure to take into account the body weight of patients;
violations of the interval between the introduction of drugs;
preservation of pale treponemas in the body despite the full-fledged specific treatment, due to their resistance to penicillin and other chemotherapy drugs in the presence of hidden, encysted lesions in the internal organs, nervous system, lymph nodes, which are inaccessible to antibacterial drugs (often pale treponemas are found in the tissues of the scar many years after the end of therapy, in the lymph nodes it is sometimes possible to detect pale treponema 3-5 years after antisyphilitic therapy);
reduction of protective forces in various diseases and intoxications (endocrinopathy, alcoholism, drug addiction, etc.);
general exhaustion (eating poor in vitamins, proteins, fats).

In addition, false positive serological reactions are often detected, not associated with the presence of syphilis in patients and caused by:

concomitant nonspecific diseases of internal organs, disorders of the cardiovascular system, rheumatism, dysfunctions of the endocrine and nervous systems, severe chronic dermatosis, malignant neoplasms;
lesions of the nervous system (severe injuries, concussion, mental trauma);
pregnancy chronic intoxication with alcohol, nicotine drugs; infectious diseases(malaria, tuberculosis, viral hepatitis, dysentery, typhus, typhoid and relapsing fever).

These factors can affect the immunological reactivity of the organism both during the period of active development of syphilitic manifestations and during their regression.

EMF analysis: description, purpose and interpretation of the analysis for syphilis

EDS, or express diagnosis of syphilis, has several names. It is known as the Wasserman reaction or as the anticardiolipin test. This is one of the most popular and effective tests for determining pale treponema, the causative agent of a disease such as syphilis.

Description and purpose of the EMF blood test

Blood test for syphilis: preparation and appointment

EMF analysis is taken not only by those who suspect that they have this disease or want to confirm an already known diagnosis, but also by all blood donors, as well as pregnant women without fail. Syphilis can be cured with antibiotics, but untreated syphilis develops into a chronic form that affects all organs in the human body, and also proceeds in the form of constant relapses and remissions.

The carrier of syphilis is a sick person, his body fluids. You can get infected through blood, sexually or through personal hygiene. The most common cause is promiscuity. The sooner the disease is detected, the easier and faster it can be cured.

In order to pass the test, it is enough to donate blood on an empty stomach. If, apart from the EMF, no more tests are needed, it is only required not to eat for 8 hours. Observe special diet the day before blood donation is not required. As a rule, blood is taken from a vein, but it can be taken from a finger, since a large amount of blood is not required.

The essence of the EMF analysis is to detect antibodies to pale treponema in the patient's blood.

If antibodies are found, then the infection has entered the body in one way or another. The cardiolipin involved in the test is a substance extracted from a bovine heart. A special cardiolipin solution is mixed with a small amount of the patient's blood in glass wells. After 30 minutes, the resulting solution is evaluated for the amount of precipitate formed.

It is worth remembering the errors. Not always a positive result means that a person is sick. Despite the effectiveness of the test, it always needs to be confirmed by other tests, donate blood several times. This is especially true for pregnant women. In addition to making a diagnosis, the test allows you to determine the stage from 1 to 4. Treatment is prescribed taking into account all the data.

Deciphering and norm of analysis for syphilis

EMF analysis: interpretation of indicators

In the case of EMF, it is difficult to talk about any norm or deviation from the norm. The result is either positive or negative. However, in addition to this, titers are also indicated, showing how much antibodies are present in the blood.

Only a doctor can decipher each specific result. There are many subtleties, so you should not make hasty conclusions, and also try to decipher the analysis yourself or via the Internet.

The cell class lgG or lgM is indicated:

As soon as treponema enters the body, a violent reaction of the immune system to the invasion of foreign cells begins.
First of all, lgM antibodies are formed. They can be detected a week after infection.
IgG antibodies appear after about a month and can persist for a long time even after successful treatment of the disease. The presence of the lgG class can only indicate that the body has developed a stable immune response to pale treponema.
If the result is the word "negative", but the credits are indicated and the word lgG is nearby, this may mean that the syphilis is secondary. That is, antibodies to pale treponema are present in the blood, but these are the so-called memory antibodies, which can circulate in the blood for a long time after recovery.

Such an analysis sometimes even gives a positive result, which is actually a false positive. To determine this, you need to take into account all previous test results and monitor the decrease in titer. In this case, all further tests can remain positive.

More information about the analysis for syphilis can be found in the video.

Next to the various letters and titles, you can see the pluses:

If there is a minus, then the result is negative.
If one plus, then doubtful
Two pluses - weakly positive
Three pluses - positive
Four pluses - sharply positive

In addition to EMF, other tests can also be taken - RIF, carried out using a luminescent microscope, or RPGA, based on the gluing of red blood cells.

It is worth considering all the results. If they are all positive, then syphilis is present. If only one is positive, there is a high probability of a false positive result. If there are two positive results, an additional test is prescribed.

Positive PED blood test result

Action on positive test result

It must be remembered that EMF analysis has its drawbacks. The purpose of the analysis is to confirm suspicions, but it is not always possible to count on a reliable result.

The Wasserman reaction can be positive not only with syphilis, but also with tuberculosis, lupus, and malaria. Unfortunately more accurate effective method Not yet. Often this analysis is taken along with everyone else in order to see the whole picture. In pregnant women, the result can be positive without the presence of any diseases. Even with menstruation, you can get a false positive result.

Those who have received a positive EMF result should adhere to the following guidelines:

It is necessary to double-check the results of the analysis several times. The patient has the right to demand confirmation, take other tests, since the reliability of the EMF analysis is not 100%.
If, in addition to the analysis, chancres, ulcers began to appear, but they still do not bleed and do not hurt, this is a sign of infection. You need to see a doctor urgently.
The patient has the right to learn all the details of the treatment, as well as the composition and effect of the drugs with which the treatment will be carried out.
During pregnancy, they can prescribe preventive treatment, which should not be abandoned. The doctor prescribes preventive courses of drugs if the woman was treated for syphilis before pregnancy or during early pregnancy.
The patient has the right to request complete anonymity. Medical secrecy prohibits the dissemination of diagnoses and treatment. In case of non-observance of anonymity, the medical institution is brought to administrative responsibility.
Do not delay treatment. In the initial stages, treatment is fast.

In the course of treatment, you will need to take an analysis of the EMF several times. Most likely, it will have to be taken repeatedly throughout life, and for quite a long time it can remain false positive.

Only a doctor can decide when a patient becomes non-infectious and can be removed from the register (usually if there is one plus in the analysis). At the time of treatment, you need to give up alcohol, heavy and fatty foods, as well as everything that complicates recovery. A negative EMF result will be evidence of the absence of the disease, it is recommended to repeat the study annually.

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Rapid test for syphilis

Diagnosis of syphilis includes:

The study of the anamnesis of life and disease.
Clinical examination of the patient.
Examination of the material from the affected areas (lymph nodes, cerebrospinal fluid, amniotic fluid) for the detection of pale treponema.
Conducting serodiagnostics (non-treponemal and treponemal tests).
Conducting additional laboratory tests (general blood and urine tests, blood biochemistry, etc.).

Non-treponemal tests can detect antibodies to phospholipids in the blood serum, which are destroyed due to this disease.

Non-treponemal tests include:

Anticardiolipin test (rapid plasma reagin test, RPR, rapid test for syphilis).
Complement fixation reaction with cardiolipin antigen (Wassermann reaction).
microscopic test.

Description and principle of action of the anticardiolipin test (RPR).

Due to the fact that the test belongs to a number of non-specific, it is possible to develop a false positive result. This is due to the fact that these antibodies can be detected in a number of other infections caused by pale treponema.

Provided that the result of this diagnostic method showed positive results, it is recommended to consult a doctor (dermatovenereologist) and re-examine using a specific treponemal test.

The study should be carried out on an empty stomach. The patient is informed that it is contraindicated to eat food for 8 hours before the analysis. You can drink a glass of water in the morning.

To date, it is possible to take tests for syphilis in medical institutions, both public and private. Tests for syphilis in any type of laboratory must be conducted anonymously.

With a titer of 1:2 to 1:320 and above, the result of an express test to confirm the diagnosis of syphilis is considered positive.

The result is considered negative in the absence of antibodies. Doubtful reaction - low titers of antibodies.

You can also buy a syphilis test kit at the pharmacy to use at home.

RPGA blood test: preparation for delivery and analysis of the results

More reliable tests for diagnosing a disease are considered to be studies that can detect specific antigens of the causative agent of the disease or antigen-antibody complexes.

These treponemal tests include:

Immunofluorescence reaction (RIF).
Passive agglutination reaction (RPHA).
Enzyme immunoassay (ELISA).
Treponema palidum immobilization reaction.
Immunobloding.

What is a RPHA blood test?

Preparing the patient for the test:

The study is shown to be carried out on an empty stomach.
You should limit fluid intake (in the evening and in the morning you can drink a glass of plain water).
It is recommended to take the analysis in the first half of the day.
For 30 minutes it is strictly contraindicated to smoke.
The content of alcohol in the blood is unacceptable.

If all of the above recommendations are not followed, the risk of developing false positive results increases.

Deciphering blood test data on RW:

In the case of a sharply positive result of the study, the titer ranges from 1:2 to 1:800.

Express analysis for syphilis, price

Rapid analysis for syphilis is based on the detection of antiphospholipid antibodies in the blood of patients. The rapid method for the diagnosis of syphilis (RPR) belongs to the category of non-specific serological tests. The RPR method is the prototype of the Wasserman (RW) reaction, it is quite sensitive and gives a positive result immediately after the appearance of the primary chancre (corresponding to the term 3-5 weeks after infection). Rapid analysis for syphilis is effective in 90% of cases for primary syphilis and 100% for secondary.

There is a serological non-treponemal and treponemal diagnosis. Treponemal tests are the main ones, with their help the causative agent of the disease is detected.

The rapid blood test for syphilis is a non-treponemal or non-specific test. And, nevertheless, this method is simple, convenient and allows you to pass the test for syphilis quickly. The results of it is ready on the same day!

When is a rapid test for syphilis ordered?

positive symptoms;
during pregnancy;
before donating blood;
before organ transplant;
after an accidental sexual intercourse;
with promiscuity;
before the operation;
children born from sick mothers;
after household contact with a person who has pale treponema;
when changing partners.

Preparation for the delivery of an express analysis for syphilis

Express analysis for syphilis does not require preliminary preparation!

How is the analysis carried out?

Specially trained medical personnel take blood from a vein (at least 5 ml) from a patient.
Then, under laboratory conditions, erythrocytes and leukocytes are precipitated, after which cardiolipin antigen is added to the blood serum.
If after a certain period of time a dark precipitate appears in the blood serum, it contains antiphospholipid antibodies that form an antigen-antibody complex. The result in this case is considered positive.

Advantages

Express diagnostics of syphilis has a number of advantages:

speed of implementation (the result is ready on the same day);
anonymity;
the possibility of regular monitoring of treatment.

Results and interpretation of express analysis for syphilis

A negative result of a rapid analysis for syphilis occurs in cases where:

The person is not sick.
If the disease is at the stage of incubation, i.e. when 3-5 weeks have not yet passed since the infection, and antibodies to cardiolipin have not yet been developed. In this case, you need to do control test In 2 weeks.
late stage. After the secondary stage, the concentration of antibodies is significantly reduced.

A false positive RPR test result for syphilis occurs when:

The presence of serious diseases (measles, pneumonia, diabetes, tumors, tuberculosis, autoimmune diseases, hepatitis of viral etiology, etc.);
Pregnancy;
Alcoholism;
recent vaccination history;
Drug addict.

A positive rapid test result for syphilis must be confirmed by an additional complete diagnosis. The doctor conducts comprehensive examinations. If all of them also give a positive result, then we are really talking about a disease and treatment of syphilis is required.

Efficiency

Rapid blood test for syphilis RPR is a qualitative diagnostic method and can be used in most cases of suspected treponema pallidum. If the test result is positive, the patient must undergo a mandatory examination by a dermatovenereologist and re-donate blood for a specific study (treponemal).

The main specific methods for diagnosing syphilis include:

In our clinic, you can donate blood for syphilis using the RPR express method and get the results on the same day!

In addition, we perform all tests aimed at diagnosing syphilis, in this regard, the diagnosis will be made accurately!