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HelpTest Code SYPHGM Syphilis IgG/IgM
Additional Codes
ALAB: SYPHGM
Powerchart: Syphilis Screen
MA Cerner: Syphilis IgG/IgM
Specimen Requirement
Serum is required.
Additional Specimen Collection Information
Additional Specimen Collection Information
Collect blood in a serum gel tube. Red-top tubes are also acceptable. Serum should be separated from contact with the cells within 2 hours of collection. Refrigerate the specimen if unable to assay within 8 hours of collection.
- Minimum volume: 500 mcL
- Hemolysis: > 2+ not acceptable
- Lipemia: > 3+ must be ultrafuged
- Icterus: no interference ≤ 20 mg/dL
- Storage: specimen is stable for up to 7 days refrigerated; freeze at -20C for long term storage.
Thoroughly mix thawed specimens; it is also recommended to centrifuge thawed specimens to remove gross particulate matter. Avoid multiple freeze-thaw cycles (up to 3 cycles are acceptable).
Test Method
Mercy DBQ: Multiplex Flow Immunoassay; BioRad BioPlex
Medical Associates West: Immunoenzymatic ("Sandwich") Chemiluminescent Method; Roche Cobas 6000
Performance
MercyOne:
Testing is performed Monday through Sunday.
Routine: Typically completed within 24 hours after the specimen arrives at the testing site.
MA West:
Testing is performed Monday - Friday.
CPT Code Information
86780 Antibody, Treponema pallidum
Useful For
Aiding in the diagnosis of active Treponema pallidum infection
Routine prenatal screening
LOINC Code Information
24110-9 Treponema pallidum Ab [Presence] in Serum by Immunoassay
Reference Value
Nonreactive
An RPR titer is reflexed for all samples that are reactive.
All samples that are reactive for Syphilis Total and RPR will be reported to the Iowa Department of Public Health through the Public Health Interface.
Samples that are reactive for Syphilis but nonreactive for RPR are sent to Mayo for Syphilis, Ab TP-PA.
| BioPlex 2200 Syphilis Total Result | Non-treponemal Result (RPR) | RPR Titer | TPPA |
Interpretation |
|---|---|---|---|---|
| Nonreactive | Nonreactive | Not Performed | Not Performed | Syphilis infection unlikely |
| Reactive | Nonreactive | Not Performed | Sent to Mayo |
Syphilis - past or present |
| Reactive | Reactive | Performed | Not Performed | Syphilis - recent infection likely |
Limitations
- The Syphilis Total and RPR test results should be considered with other laboratory results as well as the clinical presentation of the patient.
- A nonreactive result does not exclude the possibility of exposure to T. pallidum. Antibodies may be at low or undetectable levels in incubating or early primary disease and in some clinical conditions. Therefore results need to be interpreted with caution.
- Detection of treponemal antibodies may indicate recent, past or successfully treated syphilis infections and therefore cannot be used to differentiate between active and cured cases.
- Assay interference due to circulating antibodies to yaws, pinta, and bejel has not been evaluated. Cross-reactivity with these treponemal disease conditions is to be expected with treponemal antibody tests.
- Results obtained from immunocompromised individuals should be interpreted with caution.
- A patient with a Syphilis Total reactive result will usually remain reactive for life, and therefore antibody indices cannot be used to determine response to therapy.
- RPR Assay interference resulting in false positive results may occur due to cross reacting antibodies from patients diagnosed with Systemic Lupus Erythemoatosus, pregnancy, malaria, autoimmune disease, viral pneumonia, intravenous drug use, and in people who have been recently immunized (e.g., smallpox vaccination).