title: Characterization of the classical biological false-positive reaction in the serological test for syphilis in the modern era.
abstract: To characterize the CBFP reaction in the modern era, we analyzed the results of parallel rapid plasma reagin (RPR) and Treponema pallidum particle agglutination (TPPA) tests from a total of 63,765 blood samples obtained at Zhongshan Hospital in the Medical College of Xiamen University from May 2008 to February 2013. Among the 63,765 tested blood samples, 206 (0.32%) had the CBFP reaction. In multivariate analysis, an increased likelihood of the CBFP reaction was associated with female subjects, subjects ≥80years old, and subjects between 16 and 35years old (P<0.05). The CBFP reaction occurred in association with 17 categories of disease, including 60 types of diseases, in the 206 subjects. To our knowledge, a number of these diseases had not been previously reported to be associated with the CBFP in the RPR test, including false labor, megaloblastic anemias, aplastic anemias, redundant prepuce, congenital malformation of heart, and salpingitis. Among the 206 patients with the CBFP reaction, 35 patients were subjected to follow-up for five years. 26 out of 35 these patients were at a 1:1 initial RPR titer, 8 out of 35 patients were at a 1:2 initial RPR titer, and 1 out of 35 patients were at a 1:4 initial RPR titer. 30 subjects had their RPR seroreverted. In our opinion, additional CBFP research using a large sample population will contribute to the identification of additional underlying serious disorders that are not related to syphilis. Such results could be useful for the prediction and diagnosis of these diseases.
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Medical College of Xiamen University, Xiamen 361004, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Liu
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Xiamen Zhongshan Hospital, Fujian Medical University, Xiamen 361004, China; Xiamen Zhongshan Hospital, Fujian University of Traditional Chinese Medicine, Xiamen 361004, China.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Liu
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China.
authors.forename: Xiao-Jing
authors.initials: XJ
authors.lastname: Guo
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China.
authors.forename: Ya
authors.initials: Y
authors.lastname: Xi
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Xiamen Zhongshan Hospital, Fujian University of Traditional Chinese Medicine, Xiamen 361004, China.
authors.forename: Li-Rong
authors.initials: LR
authors.lastname: Lin
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China.
authors.forename: Hui-Lin
authors.initials: HL
authors.lastname: Zhang
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China.
authors.forename: Song-Jie
authors.initials: SJ
authors.lastname: Huang
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China.
authors.forename: Yu-Yan
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China.
authors.forename: Ya-Feng
authors.initials: YF
authors.lastname: Zhang
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Maternal and Child Health Hospital of Xiamen, Xiamen 361000, China.
authors.forename: Ge-Ling
authors.initials: GL
authors.lastname: Huang
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China.
authors.forename: Man-Li
authors.initials: ML
authors.lastname: Tong
authors.affiliation: The First Affiliated Hospital, Medical College of Xiamen University, Xiamen 361003, China. Electronic address: jiangjie@xmu.edu.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; ShenZhen Research Institute of Xiamen University, ShenZhen 518057, China; Xiamen Zhongshan Hospital, Fujian University of Traditional Chinese Medicine, Xiamen 361004, China. Electronic address: yangtianci@xmu.edu.cn.
authors.forename: Tian-Ci
authors.initials: TC
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D002681:China; D015897:Comorbidity; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012307:Risk Factors; D013587:Syphilis / Q000175:diagnosis* / Q000453:epidemiology*; D013588:Syphilis Serodiagnosis / Q000379:methods / Q000706:statistics & numerical data*; D014210:Treponema pallidum / Q000502:physiology*; D055815:Young Adult
keywords: Biological false positive; Nontreponemal antibody test; Rapid plasma reagin; Syphilis; Treponema pallidum particle agglutination