Syphilis Total (IgG & IgM) Antibody with Reflex

Message

Important Note

This test is useful for aiding in the diagnosis of recent or past Treponema pallidum infection
Routine prenatal screening

Test Code

SYPGM

Alias/See Also

Epic: LAB13238

Includes

If the total syphilis result is reactive or equivocal, then rapid plasma reagin (RPR) will be performed at an additional charge.

If the RPR screen result is reactive, then the RPR titer will be performed at an additional charge.

If the RPR screen result is nonreactive, then Treponema pallidum Antibody (TRPAB) will be performed at an additional charge.

Preferred Specimen

Specimen Type: Serum
Collection Container: Serum gel
Specimen Volume: 3 mL

Minimum Volume

0.5 mL

Other Acceptable Specimens

Collection Container: Red top

Instructions

Centrifuge and separate cells after clot formation and within 4 hours of collection.

Transport Container

Plastic vial

Specimen Stability

Room temperature: 72 hours
Refrigerated: 7 days
Frozen: 30 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Unlabeled, mislabeled, wrong tube type, QNS, hemolysis index >500, gross lipemia (trigs >1000 mg/dl)

Methodology

Chemiluminescent Micro-particle Immunoassay (CMIA)

Setup Schedule

Daily

Report Available

Same day

Reference Range

Nonreactive

Clinical Significance

Syphilis is caused by infection with the bacterium Treponema pallidum (TP), which is transmitted primarily by sexual contact or congenitally. The disease can present in different clinically defined stages (primary, secondary, latent, and tertiary); the latent phase is asymptomatic. Upon infection with TP, an immune response develops that is directed not only against antigens specific to TP but also antigens released during the TP-mediated cellular damage. Two types of tests have been developed as aids to diagnose syphilis, treponemal and nontreponemal. A positive treponemal test result is an indication for an acute, latent, or past infection with TP. Nontreponemal tests are especially valuable for monitoring disease activity and therapy response. It is common practice that reactive test results of either a treponemal or nontreponemal test are confirmed by a test of the complementary test type to enhance diagnostic accuracy. The ARCHITECT Syphilis TP assay is a treponemal test that detects IgG and IgM antibodies to TP. Two different algorithms, which combine a treponemal with a nontreponemal test, are used as aids in diagnosis of syphilis. The algorithm starting with the treponemal test is called reverse screening algorithm and has been implemented in laboratories due to the availability of automated treponemal tests. Samples reactive in a treponemal test are subjected to a nontreponemal supplementary test (e.g., Rapid Plasma Reagin [RPR]). The reverse screening algorithm for syphilis testing can identify persons previously treated for syphilis and those with untreated or incompletely treated syphilis. Discordant treponemal reactive, RPR-nonreactive results will be reflexed to a second treponemal test (e.g., Treponema Pallidum Particle Agglutination [TP-PA]) for further evaluation.

Performing Laboratory

Inova Laboratories

2832 Juniper Street

Fairfax, VA 22031

Last Updated: April 14, 2023
Last Review: N. Wolford, April 14, 2023

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.