Test of Cerebrospinal Fluid and Immunological Function in Patients with Syphilis Serum-resistance / 中国医师杂志

ABSTRACT

Objective To explore the possible causes that result in serum-resistance of patients with syphilis. Methods Cerebrospinal fluid(CSF) routine and biochemistry, RPR, TPPA, and immunological function in 25 patients with syphilis serum-resistance were detected after giving the standard therapy, and radiographic examination of multiple internal organs was performed as well. All patients were treated with 24 million units of Penicillin G per day by intravenous drip for 14 days followed by muscle injection of Bicillin 2.4 million units weekly for 3 weeks after leaving hospital. Blood serum RPR was reexamined 3 and 6 months after treatment, respectively. Results Among 25 patients CSF-TPPA was positive in 11 cases, all patients' CSF-RPR were negative, CSF-WBC and CSF-Pr increased in 7 patients, serum IgM level increased and C3 decreased in 10 cases (40%), and CD_3+CD_8+ cell count increased and NK cell count decreased in 21 cases (84%). The regurgitation of bicuspid valve, tricuspid valve and aortic value was found in 3 patients. The RPR titers in all patients did not decrease after treatment according to neurosyphlis. Conclusion Asymptomatic neurosyphilis and immune disorder may be causes of serum-resistance of syphilis.