[Question #9321] Follow-up, another BFP? Conclusive?

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34 months ago
Hi doctors,

This is a follow-up to my last question, but firstly, thanks again for all help and patience...

My doctor encouraged to perform follow-up testing at 8 weeks, to be sure and think more for my piece of mind (he knows I am a worrier) even though and was considering not to and questioned the need. I've seen in the threads before that you might as well if you starting on the testing path (even if not really necessary in the first place)...

I asked about the likely BFP (VDRL of 1:2), he said this must be a mistake and def. not pathological but did check with me if I had syphilis in the past (I have not). 

All came back negative (HIV negative, Hep C and specific Treponema <0.1), apart from again a VDRL of 1:2...I did email and ask and his response was that "this is completely normal, nothing to worry about", but I know it's not really "normal" and would be a lot more reassured with a "negative", which I received in a past screening. 

- Can the results at 8 weeks be considered fully conclusive? Some sources on the internet (which I realise shouldnt be looked at) say it may not show until up until 12 weeks. 

- Is there any need for further testing, to try and get a "negative" or all good to just put it behind me? 

I did have a flu vaccination in the morning of the test which I believe could be the cause, but I don't have an explanation for the initial proposed FBP.


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Edward W. Hook M.D.
33 months ago
Welcome back to the Forum.  I'll be glad to comment further.  You have the unlucky situation of having a biological false positive VRDL.  If you truly has syphilis, your VDRL titer may have changed (increased) and your specific treponemal test would certainly have become positive by now.  Some BFPs are transient but many are permanent- this appears to be the case for you.  Please don't believe what you find on the internet about needing longer time periods to be confident of the results.  They are not going to change.  

It is time for you to put this concern behind you and move forward.  You do not have syphilis.  (and your flu vaccine is not a contributor).  EWH
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33 months ago
Thanks a lot Dr. Hook. 

What I don't really understand is that, before the exposure which caused all the (most recent :-/) anxiety, I was screened and it came back "negative". It's not only an unlucky situation to get a BFP, but a pretty unfortunately timing to start getting them - any ideas what this could be attributed to? 

Just to be fully clear (also for those on the forum) - these tests are fully conclusive after 8 weeks, correct? 

Thanks again doctor and take care. 
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Edward W. Hook M.D.
33 months ago
First the easy answer- yes, your results are 100% conclusive- you do not have syphilis and no further testing is needed.

As for what caused this, that is hard to say.  BFPs can be associated with chronic inflammatory conditions but in most cases they remain unexplained.  Are you sure that your earlier negative screening test was a VDRL?  There are other types of syphilis screening tests.  In some settings Treponemal tests are used for screening, in others a test related to the VDRL but slightly different- the RPR_ is used for screening.  I wonder if perhaps your previous screening was performed using something other than the RPR.  Are you sure it was a VDRL you were screened with in the past?

EWH
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33 months ago
Thanks doctor, that's reassuring. 

Yep, 100% sure it was VDRL, I still have the lab report and checked (several times :-) - one before the encounter was negative, the next two 1:2. Seems they always order both tests. 

I do have arthritis in a big toe joint due to a sports injury, which is pretty bad at the moment due (also due to a sports injury) as well as other sport injuries. 

I'll be sure to ask more at my next appointment (sometime in the future). 

Thanks
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Edward W. Hook M.D.
33 months ago
Thanks for the additional information.  Sports related arthritis would be a rare cause of a BFP.  

Closing the thread now.  EWH
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