Li-Rong Lin1, Dan-Hong Lin2, Man-Li Tong3, Li-Li Liu3, Jin-Yi Fan3, Xiao-Zhen Zhu3, Kun Gao3, Mei-Jun Chen3, Wei-Hong Zheng3, Hui-Lin Zhang3, Shu-Lian Li4, Hui-Ling Lin4, Zhi-Feng Lin4, Jian-Jun Niu5, Tian-Ci Yang6. 1. Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China; Xiamen Zhongshan Hospital, Fujian Medical University, Xiamen, China. 2. Medical Technology Department of Fujian Health College, Fuzhou, China. 3. Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China. 4. Xiamen Huli District Maternity and Child Care Hospital, Xiamen, China. 5. Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China; Xiamen Zhongshan Hospital, Fujian Medical University, Xiamen, China. Electronic address: niujianjun211@xmu.edu.cn. 6. Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China; Xiamen Zhongshan Hospital, Fujian Medical University, Xiamen, China. Electronic address: yangtianci@xmu.edu.cn.
Abstract
BACKGROUND: Neurosyphilis (NS) is difficult to diagnose, especially in syphilis patients with negative cerebrospinal fluid (CSF) rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) tests. METHODS: We conducted a cross-sectional study and an analysis of macrophage migration inhibitory factor (MIF) in syphilitic patients to identify a novel marker for the diagnosis of NS, with a focus on probable NS (NS with negative VDRL/RPR tests). For this purpose, CSF and serum MIF concentrations were determined in 43 NS and 43 syphilis/non-NS (N-NS) patients at the Zhongshan Hospital of the Medical College of Xiamen University from July 2014 to June 2015. Sixty-three blood donors were used as healthy controls. RESULTS: NS patients had higher CSF (median [IQR]: 8.77ng/ml [4.76-19.13]) and serum (52.58ng/ml [28.31-95.94]) MIF concentrations than N-NS patients did (4.08 [2.21-9.68] and 34.30 [19.77-59.75], respectively). Using a cut-off point of 6.63ng/ml, CSF MIF had a sensitivity of 74.42% and a specificity of 67.74% for the diagnosis of NS. The sensitivity was higher than that of CSF RPR (39.53%) and increased protein (48.84%) tests and similar to that of CSF pleocytosis (67.44%). Additionally, the sensitivity of CSF MIF, which was 92.31% for the diagnosis of probable NS, was higher than that of CSF pleocytosis (65.38%) and increased protein (53.85%) tests. By integrating all CSF parameters (pleocytosis, increased protein and MIF), the sensitivity would be improved to 100% by parallel testing, which would avoid missed diagnoses. Moreover, the specificity would be improved to 100% by the serial testing algorithm, which would again avoid misdiagnosis. CONCLUSIONS: CSF MIF concentrations can be used as a novel CSF marker to establish or exclude a diagnosis of NS. Copyright Â
BACKGROUND:Neurosyphilis (NS) is difficult to diagnose, especially in syphilis patients with negative cerebrospinal fluid (CSF) rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) tests. METHODS: We conducted a cross-sectional study and an analysis of macrophage migration inhibitory factor (MIF) in syphiliticpatients to identify a novel marker for the diagnosis of NS, with a focus on probable NS (NS with negative VDRL/RPR tests). For this purpose, CSF and serum MIF concentrations were determined in 43 NS and 43 syphilis/non-NS (N-NS) patients at the Zhongshan Hospital of the Medical College of Xiamen University from July 2014 to June 2015. Sixty-three blood donors were used as healthy controls. RESULTS:NSpatients had higher CSF (median [IQR]: 8.77ng/ml [4.76-19.13]) and serum (52.58ng/ml [28.31-95.94]) MIF concentrations than N-NSpatients did (4.08 [2.21-9.68] and 34.30 [19.77-59.75], respectively). Using a cut-off point of 6.63ng/ml, CSF MIF had a sensitivity of 74.42% and a specificity of 67.74% for the diagnosis of NS. The sensitivity was higher than that of CSF RPR (39.53%) and increased protein (48.84%) tests and similar to that of CSF pleocytosis (67.44%). Additionally, the sensitivity of CSF MIF, which was 92.31% for the diagnosis of probable NS, was higher than that of CSF pleocytosis (65.38%) and increased protein (53.85%) tests. By integrating all CSF parameters (pleocytosis, increased protein and MIF), the sensitivity would be improved to 100% by parallel testing, which would avoid missed diagnoses. Moreover, the specificity would be improved to 100% by the serial testing algorithm, which would again avoid misdiagnosis. CONCLUSIONS: CSF MIF concentrations can be used as a novel CSF marker to establish or exclude a diagnosis of NS. Copyright Â
Authors: Rosanna W Peeling; David Mabey; Mary L Kamb; Xiang-Sheng Chen; Justin D Radolf; Adele S Benzaken Journal: Nat Rev Dis Primers Date: 2017-10-12 Impact factor: 52.329
Authors: Gustavo Henrique Pereira Boog; João Vitor Ziroldo Lopes; João Vitor Mahler; Marina Solti; Lucas Tokio Kawahara; Andre Kakinoki Teng; João Victor Taba Munhoz; Anna S Levin Journal: BMC Infect Dis Date: 2021-06-14 Impact factor: 3.090