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

CPT

86592

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

Test Details

Methodology

Charcoal flocculation and chemiluminescence immunoassay

Result Turnaround Time

1 - 2 days

Related Documents

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.

Specimen Requirements

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.

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.

Custom Additional Information

RPRRPR titerTreponemal Ab (TPAb)Interpretation
NonreactiveNot performedNot performedNo laboratory evidence of syphilis. If recent exposure is suspected, submit a new sample for testing in 2-4 weeks.
Reactive1:1 or higherNonreactiveNontreponemal 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.
Reactive1:1 or higherReactiveTreponemal 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.

Specimen

Serum

Volume

2 mL

Minimum Volume

1 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Maintain specimen at room temperature.

Causes for Rejection

Hemolysis; lipemia; gross bacterial contamination; plasma specimen

Stability Requirements

TemperaturePeriod
Room temperature14 days
Refrigerated14 days
Frozen14 days
Freeze/thaw cyclesStable x3

Reference Range

Nonreactive

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
Order Code012005
Order Code NameRPR, Rfx Qn RPR/Confirm TP
Order Loinc20507-0
Result Code006072
Result Code NameRPR
UofM
Result LOINC20507-0
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 1
Order Code006464
Order NameRPR, Quant.
Result Code006464
Result NameRPR, Quant.
UofMtiter
Result LOINC31147-2
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 1
Order Code012021
Order NameRPR Qn+TP Abs
Result Code006464
Result NameRPR, Quant.
UofMtiter
Result LOINC31147-2
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
Reflex 1
Order Code012021
Order NameRPR Qn+TP Abs
Result Code082371
Result NameTreponema pallidum Antibodies
UofM
Result LOINC47236-5
Reflex Table for RPR
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 012021 RPR Qn+TP Abs 010002 Interpretation: 93479-4
Reflex 1
Order Code012021
Order NameRPR Qn+TP Abs
Result Code010002
Result NameInterpretation:
UofM
Result LOINC93479-4