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Lab Dept:
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Serology
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Test Name:
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RPR (SYPHILIS IGG W/REFLEX TO RPR)
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General Information
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Lab Order Codes:
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RPRM
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Synonyms:
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VDRL; Rapid Plasma Reagin; ART; Syphilis Test; Syphilis IgG
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CPT Codes:
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86780 – Syphilis Ab, IgG
86592 – Syphilis test; qualitative (if appropriate, with an additional charge)
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Test Includes:
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If Syphilis IgG is positive, RPR (Rapid Plasma Reagin) will be performed at an additional charge as confirmation.
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Logistics
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Test Indications:
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An aid in the diagnosis of active Treponema pallidum infection.
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Lab Testing Sections:
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Serology - Sendouts
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Referred to:
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Mayo Medical Laboratories (MML Test: SYPHG/81814)
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Phone Numbers:
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MIN Lab: 612-813-6280
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STP Lab: 651-220-6550
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Test Availability:
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Daily, 24 hours
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Turnaround Time:
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1 – 4 days
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Special Instructions:
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N/A
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Specimen
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Specimen Type:
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Blood
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Container:
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Red top tube, plain, no gel
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Draw Volume:
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2 mL (Minimum: 1.2 mL) blood
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Processed Volume:
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0.75 mL (0.5 mL) serum
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Collection:
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Routine venipuncture
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Special Processing:
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Lab Staff: Centrifuge specimen, remove serum aliquot into screw-capped round bottom plastic vial. Store and ship at refrigerated temperatures. Forward promptly.
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Patient Preparation:
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None
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Sample Rejection:
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Gross hemolysis; warm specimens; gross lipemia; mislabeled or unlabeled specimens
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Interpretive
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Reference Range:
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Negative
Note: A positive IgG treponemal test suggests infection with Treponema pallidum at some point in the past, but does not distinguish between treated and untreated infections. This is because treponemal tests may remain reactive for life, even following adequate therapy. Therefore, the results of a nontreponemal assay, such as rapid plasma regain (RPR) are needed to provide information on a patient’s disease state and history of therapy.
Interpretation of results for syphilis IgG and RPR:
Syphilis IgG positive and RPR positive: Untreated syphilis unless ruled out by treatment history. Patients who have been treated in the past may be considered to have new syphilis infection if RPR titers show 4-fold, or greater, increase between acute and convalescent phase specimens.
Syphilis IgG positive and RPr negative: Past, successfully treated syphilis in patients with history of appropriate therapy. In those patients without a history of treatment, a second treponemal assay (FTA_ABS) should be performed to determine if the results of the first treponemal-specific assay were truly positive.
Syphilis IgG negative: No evidence of infection. If clinically indicated, a second specimen should be submitted in 1 to 2 weeks for follow-up testing.
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Critical Values:
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N/A
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Limitations:
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This test is not offered as a screening or confirmatory test for blood donor specimens. Despite active syphilis, serologic tests may be negative in severely immunosuppressed patients such as those with AIDS. In very early cases of primary syphilis, both IgM and IgG serologies may be negative. In cases of old, successfully treated infection (>10 years earlier), both IgG and IgM serologies may be negative. Results should be considered in the context of all available clinical and laboratory data.
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Methodology:
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Syphilis IgG: Multiplex Flow Immunoassay
RPR: Flocculation
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References:
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Mayo Medical Laboratories December 2012
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Updates:
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12/18/12: Test moved from internal test at Children’s to a referral to Mayo.
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