Test Catalog

Test Id : RPRRT

Rapid Plasma Reagin Screen Response to Therapy, Serum

Useful For
Suggests clinical disorders or settings where the test may be helpful

Determining the current disease status and evaluating response to therapy for syphilis

 

This test should not be used as a primary diagnostic approach for syphilis.

 

This test is not useful for testing spinal fluid specimens.

 

This test is not intended for medical-legal use.

Highlights

This assay provides a rapid plasma reagin (RPR) screen and can be used to monitor response to therapy in patients treated for syphilis infection.

Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test Id Reporting Name Available Separately Always Performed
RRPRQ RPR Titer, S No No

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If this test is positive, then the titer will be performed at an additional charge.

Method Name
A short description of the method used to perform the test

RPRRT: Multiplex Flow Immunoassay

RRPRQ: Flocculation/Agglutination

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

RPR Screen, Response to Therapy, S

Aliases
Lists additional common names for a test, as an aid in searching

Rapid Plasma Reagin Test (RPR)

Syphilis G

Syphilis Serology (RPR)

Treponema pallidum (T. pallidum)

Automated Reagin Test (ART)

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If this test is positive, then the titer will be performed at an additional charge.

Specimen Type
Describes the specimen type validated for testing

Serum

Ordering Guidance

This test is for monitoring response to therapy in patients treated for a syphilis infection. To screen patients for an undiagnosed syphilis infection, order SYPHT / Syphilis Total Antibody with Reflex, Serum.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.4 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Heat-inactivated specimen Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
Frozen 14 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Determining the current disease status and evaluating response to therapy for syphilis

 

This test should not be used as a primary diagnostic approach for syphilis.

 

This test is not useful for testing spinal fluid specimens.

 

This test is not intended for medical-legal use.

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If this test is positive, then the titer will be performed at an additional charge.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Syphilis is a disease caused by infection with the spirochete Treponema pallidum. The infection is systemic, and the disease is characterized by periods of latency. These features, together with the fact that T pallidum cannot be isolated in culture, mean that serologic techniques play a major role in the diagnosis and follow-up of treatment for syphilis.

 

Patients with primary or secondary syphilis should be reexamined clinically and serologically 6 months and 12 months following treatment. Typically, rapid plasma reagin (RPR) titers decrease following successful treatment, but this may occur over a period of months to years.

 

Treatment response is generally indicated by a 4-fold (2-tube dilution) reduction in RPR titer (eg, from 1:32 to 1:8). For proper interpretation of RPR results, titers should be obtained using the same testing method, preferably at the same testing laboratory.

 

Failure of nontreponemal test titers to decline 4-fold within 6 months after therapy for primary or secondary syphilis may be indicative of treatment failure. Patients whose titers remain serofast should be reevaluated for HIV infection.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Nonreactive

Interpretation
Provides information to assist in interpretation of the test results

Reactive:

Specimen reflexed to determine rapid plasma reagin (RPR) titer value.

 

Nonreactive

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Biological false-positive reactions with cardiolipin-type antigens have been reported in disease such as infectious mononucleosis, leprosy, malaria, lupus erythematosus, vaccinia, and viral pneumonia. Pregnancy, autoimmune diseases, and narcotic addictions may give false-positive results. Pinta, yaws, bejel, and other treponemal diseases may also produce false-positive results with this test.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Workowski KA, Berman S: Sexually transmitted diseases treatment guidelines. MMWR Morb Mortal Weekly Rep. 2006 Aug 4;(55);22-30

2. Miller JN: Value and limitations of nontreponemal and treponemal tests in the laboratory diagnosis of syphilis. Clin Obstet Gynecol. 1975 Mar 18;18(1);191-203. doi: 10.1097/00003081-197503000-00017

3. Morshed M, Singh AE: Recent trends in the serologic diagnosis of syphilis. Clin Vaccine Immunol. 2015 Feb;22(2):137-147. doi: 10.1128/CVI.00681-14

Method Description
Describes how the test is performed and provides a method-specific reference

For the initial automated rapid plasma reagin (RPR) screen, cardiolipin antigen-coated fluoromagnetic beads with unique fluorescent signatures are used to identify nontreponemal reagin antibodies in human serum. Dyed microparticle beads are coated with cardiolipin antigen. The BioPlex 2200 System combines an aliquot of patient sample, sample diluent, and bead reagent into a reaction vessel. The mixture is incubated at 37 degrees C. After a wash cycle, antibodies conjugated to phycoerythrin (PE) are added to the dyed beads, and this mixture is incubated at 37 degrees C. The excess conjugate is removed in another wash cycle, and the beads are resuspended in wash buffer. The bead mixture then passes through the detector. The identity of the dyed beads is determined by the fluorescence of the dyes, and the amount of nontreponemal reagin antibodies captured by the reagin is determined by the fluorescence of the attached PE. Raw data is calculated in relative fluorescence intensity (RFI).(Package insert: BioPlex 2200 Syphilis Total and RPR. Bio-Rad; 06/2017)

 

If the RPR screen is reactive, an RPR titer test is performed reflexively using a manual method. The RPR titer test is a macroscopic screening assay done with unheated serum. Reagin reacts with non-treponemal antigen containing colloidal charcoal particles. This reaction results in a visual flocculation of the black particles against the white card background. The test yields a positive or negative result, and all positive samples are titered to determine the highest positive dilution.(Huber TW, Storms S, Young P, et al: Reactivity of microhemagglutination, fluorescent treponemal antibody absorption, Venereal Disease Research Laboratory, and rapid plasma reagin tests in primary syphilis. J Clin Microbiol. 1983 Mar;17[3]:405-409; Kaur G, Kaur P: Syphilis testing in blood donors: an update. Blood Transfus. 2015 Apr;13[2]:197-204. doi: 10.2450/2014.0146-14)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

0065U (PLA Code)

86593-Rapid Plasma Reagin Titer (if appropriate)

LOINC® Information

Test Id Test Order Name Order LOINC Value
RPRRT RPR Screen, Response to Therapy, S 47236-5
Result Id Test Result Name Result LOINC Value
Result LOINC Value Tooltip
RPRRT RPR Screen, Response to Therapy, S 20507-0

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports