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May 27, 1968

Biologic False-Positive Reactions for Syphilis

JAMA. 1968;204(9):833. doi:10.1001/jama.1968.03140220081032

To the Editor:—  The problem posed (203:996, 1968) regarding a 54-year-old housewife with a reactive fluorescent Treponemal antibody test merits an expanded discussion particularly of the possibility of a biologic false-positive (BFP) reaction. Syphilis is the great mimic, and we of the Osler tradition recall, "When it comes to syphilis, suspect your grandmother." The experienced physician, however, occasionally finds a positive reaction he is forced to classify as BFP.Garson,1 after an excellent discussion of the tests for syphilis developed before 1959, said: "No serologic test for syphilis diagnoses syphilis; rather it informs us of the immunologic status of the patient in relation to the antibody being treated. None... is absolutely specific for syphilis alone."In Current Diagnosis (1966) Beerman2 points out the possibility of reactivity not only in syphilis and related treponemal diseases such as "yaws, pinta, or beje," but also in various other states such