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Fear Of Syphilis. Tested RPR Positive During Pregnancy. Have High Vitamin D1 Level. Related To Lyme Disease?

Posted on Wed, 10 Apr 2013

Question: Hello,
I have always been concerned about STDs. Every once in a while my concern comes back even though I have been married and in a monogamous relationship for many years. I have a fear of syphillis. I have never had symptoms but I am worried about it from many years ago in high school, about 18 years now. I was tested with the RPR in my first pregnancy and that was 9 years ago and then 2 years ago with my second pregnancy and both were nonreactive. Could I still have this? I am obsessing that I will get nuerosyphillis. i am worried about accuracy or would that have been picked up in one of those tests? Do you know the accuracy percentages?
I've just recently had a vitamin d 1, 25 hydroxy test come up high, so I'm panicking about that. It was at 99. I read it could be related to autoimmune processes, including Lyme disease and lymphoma. I'm assuming that since Lyme and syphills are similar that that would be the same case??

Answered by Dr. Ram Choudhary (7 hours later)

Hi,You seem to be undue anxiously about syphilis, while you have practically rule out the possibility of syphilis in your case.In suspected syphilis, first perform nontreponemal serology screening using the Venereal Disease Research Laboratory(VDRL), rapid plasma reagin (RPR) tests. These tests have good sensitivity and specificity.Sensitivity of the VDRL and RPR tests areestimated to be 78-86% for detecting primary syphilis, 100% for detecting secondary syphilis, and 95-98% for detecting tertiary syphilis. Specificity ranges from 85-99% and may be reduced in individuals who have coexisting conditions (ie, collagenvascular disease, pregnancy, intravenousdrug use, advanced malignancy, tuberculosis,malaria, viral and rickettsial diseases).VDRL test results turn positive 1-2 weeksafter chancre formation. Nontreponemal tests usually become nonreactive with time after treatment.You should not be worried any more regarding syphilis.I wish you a great health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ram Choudhary (2 hours later)

Thank you for your answer. Some sites i read tell of those tests being less effective in late syphills And that is my concern that it wasn't picked up. Do you have any information on the increases levels of d 1, 25 dihydroxy test?

Answered by Dr. Ram Choudhary (24 hours later)

Hi XXXXXXX
Welcome back to Healthcare Magic!
The tests have fair sensitivity and specificity even in late course.
In extremely late course where disease is in waning out it may have less sensitivity but before that the patient would have apparently many symptoms which is not the case with you.
The causes for raised levels of vit.D in blood are many and unrelated to the occurrence of syphylis, can be related to excess input of the suppliments as well if you are having any.
I hope that answers your query.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar