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Can A Certified MD Order A TPPA Confirmatory Syphilis Test That Has Turned Up Negative?

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Posted on Sun, 24 Jun 2012
Question: Can a certified MD in very good standing order an FTA ABS or a TPPA confirmatory syphilis test from a large reputable lab in conjunction with an RPR test that has turned up negative. This is for what would have been a sexual contact over 40 years ago. I have been totally sexually monogamous with my wife since then. My information is that the lab will not perform the confirmatory test UNLESS the RPR screening test is positive. I was told that an RPR screening test very well may show a false negative after 40 years but the above mentioned confirmatory tests ( without any treatment for syphilis) are accurate for life regardless of the intervening time period. I want to have a confirmatory test done to put my mind at ease. I am very worried as of now. If the lab can over ride a doctors order.then in my opinion this is the perfect case of the tail wagging the dog. I understand that the test is expensive but that is not a problem for me. If you know of any way I can have this confirmatory test performed regardless of the result of a negative RPR please let me know. If I know I can have this test performed it would GREATLY help me. I could relax again.
Thank you, XXXXXXX
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Answered by Dr. P V S Prasad (12 hours later)
Hi,

Thanks for posting the query.

I read your problem. Any doctor can ask for some test on the basis of clinical suspicion. If the laboratory refuses to do the test it is purely a local problem and the concerned doctor has to convince the lab or find some other lab.

Doing the test in another country is difficult as it involves restriction in transporting blood samples. Hence I am helpless in this regard. RPR (Rapid Plasma Reagin) may show both false positive and false negative results. RPR is only a non specific test for syphilis. However, if they do VDRL (Venereal Disease Research Laboratory) test that may be more useful.

Hope I have answered your query. Please accept my answer in case you do not have further queries.

Regards,
Prasad PVS

Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. P V S Prasad

Dermatologist

Practicing since :1980

Answered : 254 Questions

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Can A Certified MD Order A TPPA Confirmatory Syphilis Test That Has Turned Up Negative?

Hi,

Thanks for posting the query.

I read your problem. Any doctor can ask for some test on the basis of clinical suspicion. If the laboratory refuses to do the test it is purely a local problem and the concerned doctor has to convince the lab or find some other lab.

Doing the test in another country is difficult as it involves restriction in transporting blood samples. Hence I am helpless in this regard. RPR (Rapid Plasma Reagin) may show both false positive and false negative results. RPR is only a non specific test for syphilis. However, if they do VDRL (Venereal Disease Research Laboratory) test that may be more useful.

Hope I have answered your query. Please accept my answer in case you do not have further queries.

Regards,
Prasad PVS