Tabes Dorsalis diagnostic study of choice: Difference between revisions

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__NOTOC__
__NOTOC__
{{Tabes dorsalis}}
{{Tabes dorsalis}}
{{CMG}}; {{AE}}
{{CMG}}; {{AE}}{{MMJ}}
== Overview ==
== Overview ==
The first step laboratory test when there is a clinical suspicious toward tabes dorsalis is a  [[Venereal Disease Research Laboratory test|venereal disease research laboratory test (VDRL)]]  or [[Rapid plasma reagent|rapid plasma reagin (RPR)]]. [[FTA-ABS|Fluorescent treponemal antibody absorbed (FTA-ABS) test]] is the gold standard test for the diagnosis of tabes dorsalis.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
===== Template statements =====


=== Study of choice: ===
=== Study of choice: ===
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* The first step laboratory test when there is a clinical suspicious toward tabes dorsalis is a  [[Venereal Disease Research Laboratory test|venereal disease research laboratory test (VDRL)]] or [[Rapid plasma reagent|rapid plasma reagin (RPR)]].
* The following result of [gold standard test] is confirmatory of [disease name]:
* [[FTA-ABS|Fluorescent treponemal antibody absorbed (FTA-ABS) test]] is the gold standard test for the diagnosis of tabes dorsalis.<ref name="pmid20846810">{{cite journal| author=Lin LR, Fu ZG, Dan B, Jing GJ, Tong ML, Chen DT et al.| title=Development of a colloidal gold-immunochromatography assay to detect immunoglobulin G antibodies to Treponema pallidum with TPN17 and TPN47. | journal=Diagn Microbiol Infect Dis | year= 2010 | volume= 68 | issue= 3 | pages= 193-200 | pmid=20846810 | doi=10.1016/j.diagmicrobio.2010.06.019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20846810  }} </ref>
** Result 1
* The [[FTA-ABS|fluorescent treponemal antibody absorbed (FTA-ABS) test]] should be performed when:
** Result 2
** A positive [[Venereal Disease Research Laboratory test|venereal disease research laboratory test (VDRL)]] or [[Rapid plasma reagent|rapid plasma reagin (RPR)]] is detected in the patient.
* The [name of the investigation] should be performed when:
** The patient presented with symptoms/signs 1. 2, 3.
** A positive [test] is detected in the patient.
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* The diagnostic study of choice for [disease name] is [name of the investigation].
* There is no single diagnostic study of choice for the diagnosis of [disease name].
* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
* [Disease name] is mainly diagnosed based on clinical presentation.
* Investigations:
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.


==== The comparison table for diagnostic studies of choice for [disease name] ====
==== The comparison table for diagnostic studies of choice for tabes dorsalis ====
{|
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|- style="background: #4479BA; color: #FFFFFF; text-align: left;"
! style="background: #FFFFFF; color: #FFFFFF; text-align: center;" |
! style="background: #FFFFFF; color: #FFFFFF; text-align: left;" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: left;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
! style="background: #4479BA; color: #FFFFFF; text-align: left;" |Specificity
|-
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
! style="background: #696969; color: #FFFFFF; text-align: center;" |FTA-ABS
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
| style="background: #DCDCDC; padding: 5px; text-align: left;" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
* 84% for detecting primary [[syphilis]] infection
* 100% sensitivity for detecting [[syphilis]] infection in secondary and tertiary stages<ref name="pmid15335137" />
| style="background: #DCDCDC; padding: 5px; text-align: center;" |96%<ref name="pmid15335137">{{cite journal| author=Calonge N, U.S. Preventive Services Task Force| title=Screening for syphilis infection: recommendation statement. | journal=Ann Fam Med | year= 2004 | volume= 2 | issue= 4 | pages= 362-5 | pmid=15335137 | doi= | pmc=1466700 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15335137  }} </ref>
|-
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
! style="background: #696969; color: #FFFFFF; text-align: center;" |VDRL/RPR
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: left;" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
* 78% to 86% for detecting primary syphilis infection
* 100% for detecting secondary syphilis infection, and 95% to 98% for detecting latent syphilis infection<ref name="pmid15335137" />
| style="background: #DCDCDC; padding: 5px; text-align: left;" |85% to 99%<ref name="pmid15335137" />
|}
|}
<small> ✔= The best test based on the feature </small>
===== Diagnostic results =====
The following result of [investigation name] is confirmatory of [disease name]:
* Result 1
* Result 2
===== Sequence of Diagnostic Studies =====
The [name of investigation] should be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
=== Diagnostic Criteria ===
* Here you should describe the details of the diagnostic criteria.
*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
** Criteria 1
** Criteria 2
** Criteria 3
IF there are clear, established diagnostic criteria:
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria: 
*There are no established criteria for the diagnosis of [disease name].


==References==
==References==

Latest revision as of 15:35, 19 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

The first step laboratory test when there is a clinical suspicious toward tabes dorsalis is a venereal disease research laboratory test (VDRL) or rapid plasma reagin (RPR). Fluorescent treponemal antibody absorbed (FTA-ABS) test is the gold standard test for the diagnosis of tabes dorsalis.

Diagnostic Study of Choice

Study of choice:

The comparison table for diagnostic studies of choice for tabes dorsalis

Sensitivity Specificity
FTA-ABS
  • 84% for detecting primary syphilis infection
  • 100% sensitivity for detecting syphilis infection in secondary and tertiary stages[2]
 96%[2]
VDRL/RPR
  • 78% to 86% for detecting primary syphilis infection
  • 100% for detecting secondary syphilis infection, and 95% to 98% for detecting latent syphilis infection[2]
 85% to 99%[2]

References

  1. ↑ Lin LR, Fu ZG, Dan B, Jing GJ, Tong ML, Chen DT; et al. (2010). "Development of a colloidal gold-immunochromatography assay to detect immunoglobulin G antibodies to Treponema pallidum with TPN17 and TPN47". Diagn Microbiol Infect Dis. 68 (3): 193–200. doi:10.1016/j.diagmicrobio.2010.06.019. PMID 20846810.
  2. ↑ 2.0 2.1 2.2 2.3 Calonge N, U.S. Preventive Services Task Force (2004). "Screening for syphilis infection: recommendation statement". Ann Fam Med. 2 (4): 362–5. PMC 1466700. PMID 15335137.

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