Prozone phenomenon
Encyclopedia
The prozone phenomenon is defined as a falsely negative (=incorrectly normal) test due to very high titer
Titer
A titer is a way of expressing concentration. Titer testing employs serial dilution to obtain approximate quantitative information from an analytical procedure that inherently only evaluates as positive or negative. The titer corresponds to the highest dilution factor that still yields a positive...

s (concentration) of antibody
Antibody
An antibody, also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen...

.

Many laboratory tests rely on antigen-antibody interactions. The prozone phenomenon is said to be present when dilution of a previously negative sample leads to a positive test. High levels of antigen or antibody may prevent the formation of antigen-antibody complexes.

Examples include high levels of syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

 antibodies in HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

patients or high levels of cryptococcal antigen leading to false negative tests in undiluted samples. This phenomenon is also seen in serological tests for Brucellosis.
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