[Immunoblotting for the serodiagnosis of syphilis. A candidate to replace the Nelson-Mayer test].

The lipid antigens used in the Bordet-Wassermann and prepared by Landsteiner and Marie for syphilis tests from 1909 to 1949 were non specific but have certain common features with the spirochete body. For more than forty years the Bordet-Wassermann reaction, associated with flocculation (Kahn) or agglutination (Kline-VDRL) was used to detect cases of tremonematosis despite frequent false positives reactions due to other infections. In 1949, the Nelson and Mayer test was introduced.

[Lyme disease].

After a short historical review of the Lyme disease, the author describes the responsible bacteria, a Spirochete called Borrelia. Epidemiology, physiopathology and clinical manifestations are studied, as well as the different phases of the disease (primary secondary and tertiary) and the various possible symptoms (dermatological, cardiovascular, rheumatical, neurological syndrome). The biological part includes isolation of the Bacteria and detection of antibodies (IFI, ELISA, passive hemagglutination and Western Blot).

Syphilis serology in 1991.

Syphilis, the third most common sexually transmitted disease, has numerous clinical manifestations and can remain entirely latent for many years. This article gives an overview of diagnosis, evolution of antibodies, specific cases and types of syphilis, and implications for immunodeficient patients.

Ocular Lyme borreliosis.

In six patients with ocular Lyme borreliosis, bilateral granulomatous iridocyclitis and vitritis were present in five. One of these five also had bilateral optic neuritis. Another patient developed combined trochlear and facial nerve palsies.

The prevalence of Lyme disease in a nonendemic area. A comparative serologic study in a south Florida eye clinic population.

Serologic tests for Lyme borreliosis and for syphilis were performed on 75 patients seen in a 1-week period at the Bascom Palmer Eye Institute in Miami. The incident of syphilis was 8% and of Lyme borreliosis 3% in this study in a nonendemic area. The most common cause for a high titer serologic response for Lyme borreliosis in this group was a prior Treponema pallidum infection.

An evaluation of ELISA kits for rubella IgG- and IgM-antibodies.

Two ELISA kits for rubella IgG- and IgM-antibodies, respectively, were compared with a haemagglutination inhibition (HAI) test (after ultracentrifugation of the sample if IgM was to be detected). When screening 535 samples from pregnant women, 99.6% agreement was found between the IgG-ELISA and HAI; one true IgM-positive was encountered in this group with the IgM-ELISA.

Importance of specific IgM antibodies in 116 patients with various stages of syphilis.

We tested 222 serum samples obtained from 51 patients presenting with syphilis, before and after treatment; 117 from 65 patients with a history of syphilis (114) or yaws (3); 77 from 71 patients with no evidence of syphilis; and 1117 serologically negative serum samples. Our tests included the IgM fluorescent treponemal antibody absorbed (IgM-FTA-ABS) and solid phase haemadsorption assay (SPHA) techniques. According to the stage of development of syphilis, IgM antibodies were found in 83-100% of the serum samples.

Automation of a flocculation test for syphilis on Groupamatic equipment.

A flocculation reaction employing a cardiolipid antigen was used for syphilis screening on Groupamatic equipment in parallel with conventional screening reactions: Kolmer CF, RPCF, Kahn, Kline, and RPR. The positive samples were confirmed by FTA-200, FTA-ABS, TPI, and in some cases by TPHA. There were 5,212 known samples which had already been tested by all methods and of which 1,648 were positive, and 58,636 screened samples including 65 positives.