Syphilis: RPR With Reflex to RPR Titer and Treponemal Antibodies, Traditional Screening and Diagnosis Algorithm

CPT: 86592
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Synonyms

  • Nontreponemal Test
  • Serological Tests for Syphilis (STS)
  • Syphilis Serology

Test Includes

RPR, qualitative; RPR titer; and Treponema pallidum-specific test on reactives. An additional fee is charged when a confirmatory Treponema pallidum test is performed.


Expected Turnaround Time

1 - 2 days


Related Documents


Specimen Requirements


Specimen

Serum


Volume

2 mL


Minimum Volume

1 mL


Container

Red-top tube or gel-barrier tube


Storage Instructions

Maintain specimen at room temperature.


Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3


Causes for Rejection

Hemolysis; lipemia; gross bacterial contamination; plasma specimen


Test Details


Use

This test is intended to support screening and diagnosis of syphilis infections. This test aligns with the CDC-supported traditional serologic testing algorithm for syphilis using a combination of both treponemal and nontreponemal antibody tests. The traditional syphilis testing algorithm begins with the RPR (nontreponemal) test with positive samples reflexing to RPR titer and treponemal antibody testing. Interpretation of results obtained must take into account patient symptoms and clinical history.


Limitations

Biological false positive results (RPR-reactive, Treponemal antibody-negative) have been associated with infections other than syphilis, as well as recent immunization, autoimmune disorders, pregnancy and injection drug use.


Methodology

Charcoal flocculation and multiplex flow immunoassay


Reference Interval

Nonreactive


Additional Information

RPR

RPR titer

Treponemal Ab (TPAb)

Interpretation

Nonreactive

Not performed

Not performed

No laboratory evidence of syphilis. If recent exposure is suspected, submit a new sample for testing in 2-4 weeks.

Reactive

1:1 or higher

Nonreactive

Nontreponemal antibodies detected. Syphilis unlikely; biological false positive possible. Clinical evaluation should be performed to identify current signs and symptoms or past history of infection or treatment. If recent exposure is suspected, submit a new sample for testing in 2-4 weeks.

Reactive

1:1 or higher

Reactive

Treponemal and nontreponemal antibodies detected. Consistent with past or current (potentially early) syphilis. Clinical evaluation should be performed to identify current signs and symptoms or past history of infection or treatment.


LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
012005 RPR, Rfx Qn RPR/Confirm TP 20507-0 006072 RPR 20507-0
Reflex Table for RPR
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 006464 RPR, Quant. 006464 RPR, Quant. titer 31147-2
Reflex Table for RPR
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 012021 RPR Qn+TP Abs 006464 RPR, Quant. titer 31147-2
Reflex Table for RPR
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 012021 RPR Qn+TP Abs 082371 Treponema pallidum Antibodies 47236-5

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