{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T06:34:46Z","timestamp":1762842886726,"version":"build-2065373602"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The issue of biological false positives in syphilis diagnosis is gaining attention. However, limited focus exists on false positives in syphilis tests among younger populations. This study investigates the epidemiological characteristics and influencing factors of false positive serological test results for syphilis in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted on the serological test results, demographic, clinical, and laboratory characteristics of children in Jinling Hospital from 2017 to 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study included 18 cases of false positive syphilis results. Children aged 5\u20139 years had a higher proportion of false positives compared to those with negative results (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The prevalence of adenoid hypertrophy (AH) in children with false positives was 38.89%, significantly higher than in those with negative results (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001). The results of syphilis antibodies detection by enzyme-linked immunosorbent assay (EIA) in false positive cases, negative cases, and true positive cases were significantly different (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001). Children with false-positive syphilis results had significantly higher systemic immune-inflammation index (SII), fibrin degradation products (FDP), and platelet (PLT) levels than those with negative results (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Compared to true-positive cases, false-positive cases showed lower systemic inflammation response index (SIRI) and neutrophil-to-lymphocyte ratio (NLR) but higher lymphocyte-to-monocyte ratio (LMR), antithrombin III (AT-III), and PLT levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Furthermore, among children with false-positive serological test results for syphilis, certain coagulation parameters, such as FDP, D-dimer (DD), AT-III, and PLT, were found to be elevated (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Univariate logistic regression analysis revealed that age (OR\u2009=\u20090.852, 95% CI: 0.766, 0.948), AH (OR\u2009=\u200920.10, 95% CI: 5.361, 79.53), APTT (OR\u2009=\u20090.804, 95% CI: 0.658, 0.977), FDP (OR\u2009=\u20091.722, 95% CI: 1.234, 2.416), AT-III (OR\u2009=\u20091.071, 95%CI: 1.030, 1.121), and PLT (OR\u2009=\u20091.008, 95%CI: 1.003, 1.013) were risk factors associated with the occurrence of a false positive reaction in syphilis serology (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the assessment of false-positive syphilis test results, age and inflammatory marker data exhibit reference value. AH and partial coagulation function indices are risk factors for false positive syphilis serology results in children. Therefore, it is crucial for clinical and laboratory doctors to pay close attention to positive results for syphilis in such cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1671397","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T06:32:10Z","timestamp":1762842730000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with false positive results in serological testing for syphilis using EIA among children"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiaqi","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qianqian","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangchao","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuzhou","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1128\/CMR.19.1.29-49.2006","article-title":"Biological basis for syphilis","volume":"19","author":"Lafond","year":"2006","journal-title":"Clin Microbiol Rev"},{"key":"B2","year":"2024"},{"key":"B3","doi-asserted-by":"publisher","first-page":"3000605241258465","DOI":"10.1177\/03000605241258465","article-title":"Epidemiological characteristics of syphilis in mainland China, 2004 to 2019","volume":"52","author":"Li","year":"2024","journal-title":"J Int Med Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1275551","DOI":"10.3389\/fpubh.2023.1275551","article-title":"Scaling law characteristics and spatiotemporal multicomponent analysis of syphilis from 2016 to 2022 in Zhejiang province, China","volume":"11","author":"Wu","year":"2023","journal-title":"Front Public Health"},{"key":"B5","doi-asserted-by":"publisher","first-page":"S43","DOI":"10.1093\/cid\/ciaa307","article-title":"The traditional or reverse algorithm for diagnosis of syphilis: pros and cons","volume":"71","author":"Ortiz","year":"2020","journal-title":"Clin Infect Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e0047624","DOI":"10.1128\/jcm.00476-24","article-title":"Improved efficiency using sequential automated immunoassays for syphilis screening in blood donors","volume":"62","author":"Cheng","year":"2024","journal-title":"J Clin Microbiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1128\/CVI.00681-14","article-title":"Recent trends in the serologic diagnosis of syphilis","volume":"22","author":"Morshed","year":"2015","journal-title":"Clin Vaccine Immunol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.plabm.2017.04.007","article-title":"Traditional versus reverse syphilis algorithms: a comparison at a large academic medical center","volume":"8","author":"Dunseth","year":"2017","journal-title":"Pract Lab Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e0010021","DOI":"10.1128\/JCM.00100-21","article-title":"The laboratory diagnosis of syphilis","volume":"59","author":"Satyaputra","year":"2021","journal-title":"J Clin Microbiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1136\/sextrans-2020-054628","article-title":"Prevalence and clinical characteristics of patients with biologically false-positive reactions with serological syphilis testing in contemporary practice: 10-year experience at a tertiary academic hospital","volume":"97","author":"Ishihara","year":"2021","journal-title":"Sex Transm Infect"},{"key":"B11","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1080\/17843286.2019.1649081","article-title":"Serologic false-positive reactions for syphilis in children of adenoidal hypertrophy:2 case reports and review of the literature","volume":"76","author":"Wang","year":"2021","journal-title":"Acta Clin Belg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.1007\/s00296-019-04435-0","article-title":"Clinical characteristics of patients with systemic lupus erythematosus showing a false-positive result of syphilis screening","volume":"39","author":"Ahn","year":"2019","journal-title":"Rheumatol Int"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1093\/cid\/cit445","article-title":"The impact of combined antiretroviral therapy on biologic false-positive rapid plasma reagin serologies in a longitudinal cohort of HIV-infected persons","volume":"57","author":"Oboho","year":"2013","journal-title":"Clin Infect Dis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.intimp.2014.03.011","article-title":"Characterization of the classical biological false-positive reaction in the serological test for syphilis in the modern era","volume":"20","author":"Liu","year":"2014","journal-title":"Int Immunopharmacol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1136\/sti.2009.040360","article-title":"Hepatitis C virus infection and biological false-positive syphilis tests","volume":"86","author":"Augenbraun","year":"2010","journal-title":"Sex Transm Infect"},{"key":"B16","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1093\/labmed\/lmad078","article-title":"Retrospective comparison of false-positive result frequencies of 3 syphilis serology screening tests in pregnant and nonpregnant patients at an academic medical center in appalachia","volume":"55","author":"Yang","year":"2024","journal-title":"Labmedicine"},{"key":"B17","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1111\/tme.12395","article-title":"Evaluation of positive and false-positive results in syphilis screening of blood donors in Rio de Janeiro, Brazil","volume":"27","author":"Sandes","year":"2017","journal-title":"Transfusion Medicine"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/jcla.20268","article-title":"Laboratory diagnosis of syphilis with automated immunoassays","volume":"23","author":"Marangoni","year":"2009","journal-title":"J Clin Lab Anal"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e0212893","DOI":"10.1371\/journal.pone.0212893","article-title":"Urea-mediated dissociation alleviate the false-positive Treponema pallidum-specific antibodies detected by ELISA","volume":"14","author":"Qi","year":"2019","journal-title":"PLoS One"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/03946320110240S401","article-title":"Adenoids during childhood: the facts","volume":"24","author":"Marseglia","year":"2011","journal-title":"Int J Immunopathol Pharmacol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1002\/ca.22373","article-title":"Adenoids in children: advances in immunology, diagnosis, and surgery","volume":"27","author":"Brambilla","year":"2014","journal-title":"Clin Anat"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e0211","DOI":"10.1097\/MD.0000000000010211","article-title":"Roles of T follicular helper cells in the pathogenesis of adenoidal hypertrophy combined with secretory otitis media","volume":"97","author":"Feng","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1002\/jmv.27557","article-title":"The endogenous factors affecting the detection of serum SARS-CoV-2 IgG\/IgM antibodies by ELISA","volume":"94","author":"Liu","year":"2022","journal-title":"J Med Virol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"240","DOI":"10.3109\/00365513.2016.1143113","article-title":"Heterophilic antibody interference affecting multiple hormone assays: is it due to rheumatoid factor?","volume":"76","author":"Mongolu","year":"2016","journal-title":"Scand J Clin Lab Inv"},{"key":"B25","doi-asserted-by":"publisher","first-page":"011001","DOI":"10.11613\/BM.2023.011001","article-title":"Fibrin clot interference in a human chorionic gonadotrophin assay causing a false down syndrome screening result","volume":"33","author":"Akagac","year":"2023","journal-title":"Biochem Medica"},{"key":"B26","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1210\/er.2018-00119","article-title":"Interferences with thyroid function immunoassays: clinical implications and detection algorithm","volume":"39","author":"Favresse","year":"2018","journal-title":"Endocr Rev"},{"key":"B27","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13075-024-03278-w","article-title":"Regulatory T and B cells in pediatric henoch-sch\u00f6nlein purpura: friends or foes?","volume":"26","author":"Filleron","year":"2024","journal-title":"Arthritis Res Ther"},{"key":"B28","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1186\/s12887-019-1829-4","article-title":"Iga vasculitis (henoch-sch\u00f6nlein Purpura) as the first manifestation of juvenile systemic lupus erythematosus: case-control study and systematic review","volume":"19","author":"Murata","year":"2019","journal-title":"BMC Pediatr"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1007\/s00296-008-0812-4","article-title":"High factor VIII or homocysteine levels and thrombosis in henoch-sch\u00f6nlein purpura","volume":"29","author":"Shin","year":"2009","journal-title":"Rheumatol Int"},{"key":"B30","doi-asserted-by":"publisher","first-page":"103142","DOI":"10.1016\/j.autrev.2022.103142","article-title":"Alarmins in autoimmune diseases","volume":"21","author":"Danieli","year":"2022","journal-title":"Autoimmun Rev"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1365591","DOI":"10.3389\/fimmu.2024.1365591","article-title":"Association between systemic inflammatory indicators with the survival of chronic kidney disease: a prospective study based on NHANES","volume":"15","author":"Chen","year":"2024","journal-title":"Front Immunol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1115031","DOI":"10.3389\/fimmu.2023.1115031","article-title":"The clinical value of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and systemic inflammation response index (SIRI) for predicting the occurrence and severity of pneumonia in patients with intracerebral hemorrhage","volume":"14","author":"Wang","year":"2023","journal-title":"Front Immunol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1080\/00325481.2022.2091373","article-title":"Utility of the systemic immune-inflammation index to predict serious bacterial infections in infants with fever without a source","volume":"134","author":"G\u00fcng\u00f6r","year":"2022","journal-title":"Postgrad Med"},{"key":"B34","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1186\/s12887-024-04818-8","article-title":"Role of systemic immune-inflammatory index and systemic inflammatory response index in predicting the diagnosis of necrotizing pneumonia in children","volume":"24","author":"Elmeazawy","year":"2024","journal-title":"BMC Pediatr"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1671397\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T06:32:11Z","timestamp":1762842731000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1671397\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,11]]},"references-count":34,"alternative-id":["10.3389\/fped.2025.1671397"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1671397","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,11]]},"article-number":"1671397"}}