Abstract

he aim of this study was to assess the amount of IgM specific anti-treponemal antibodies present in the cerebrospinal fluid (CSF) of early and tarda syphilis patients, as an indicative factor of early central nervous system (CNS) treponemal infection. The study group comprised 124 patients (79 men and 45 women, aged between 18 and 70), out of which 40 presented with untreated early syphilis and 84 with syphilis tarda (9 untreated and 75 previously treated patients). Specific IgM anti-treponemal antibodies were determined by means of the CAPTIA Syphilis-M immunoenzymatic reaction (Centocor Inc. USA). In order to confirm diagnosis, we also used the TPHA passive hemagglutination reaction and the FTA-ABS treponemal immunofluorescence method. The blood-CSF barrier was evaluated by means of the albumin index (ratio). The amount of albumin in blood and the CSF was determined by means of the turbidimetric method using a Behring Turbitimer aparatus. We determined the presence of specific IgM anti-treponemal antibodies in secondary syphilis (68% of patients) and in early latent syphilis (44% of patients). This demonstrates that infection of the central nervous system occurs in early syphilis, which in untreated, late treatment or ineffectively treated cases might lead to the development of central nervous system syphilis.

Keywords: blood-CSF barrier, Serology, Captia syphilis-M, cerebrospinal fluid (CSF), syphilis