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Syphilis Screen Cascade (Treponemal Screen)

Message
For patients < 15 months, use the RPRQ1 order.
For KNOWN PAST OR CURRENT Syphilis Positive patients, use RPRTT Order  for monitoring status or treatment.  Treponemal IgG may remain positive for life so the Syphilis IgG assay may not be useful for patients with known IgG reactive status and past syphilis history.


Test Code
SYPH


Alias/See Also
RPR, TPPA, Syphilis, Rapid Reagin, Treponemal, Treponemal Screen, Treponemal IgG


CPT Codes
86780

Preferred Specimen
Serum SST (GOLD)


Minimum Volume
0.5 mL


Other Acceptable Specimens
EDTA (LAV) Plasma
Plasma LT Green (PST)


Specimen Stability
  • Centrifuge samples as soon as possible after collecting.
  • Store samples at 2 to 8°C if not tested immediately.  Stable up to 7 days.
  • Freeze samples, devoid of red blood cells, at or below -20°C. Thoroughly mix thawed samples and centrifuge before using.


Methodology
Siemens Centaur

Setup Schedule
24x7 CRMC Laboratory


Report Available
1-2 hours after specimen receipt


Limitations

Method Limitations
 

  1. The ADVIA Centaur SYPH assay is limited to the detection of antibodies to T. pallidum in human serum or plasma (EDTA, lithium or sodium heparinized plasma, citrated plasma).
  2. A nonreactive test result does not exclude the possibility of exposure to or infection with syphilis. T. pallidum antibodies may be undetectable in some stages of the infection and in some clinical conditions.
  3. A reactive test result does not distinguish between active syphilis and treated or otherwise inactive syphilis.
  4. The performance of the ADVIA Centaur SYPH assay has not been established with neonatal specimens, cadaver specimens, heat-inactivated specimens, or body fluids other than serum or plasma, such as saliva, urine amniotic, or pleural fluids.
  5. Assay interference due to possible circulating antibodies against pinta, yaws, and leptospirosis has not been evaluated.
  6. Do not use specimens with obvious microbial contamination.
  7. This test may remain positive even in patients successfully treated for Syphilis and so cannot distinguish active past disease.


Reference Range
Nonreactive
Reactive specimens will be referred to reference laboratory as indicated in algorithm.
                       


Clinical Significance

Syphilis is primarily transmitted via sexual contract, but can be transmitted from mother to fetus.  Syphilis is caused by the spirochette T. pallidum, which has never been successfully cultured in artificial media.  Syphilis infections are classified into early (infectious) and late (non-infectious) stages.  Early syphilis may be further divided into primary, secondary, and early latent syphilis.  The sign and symptoms of syphilis are numerous; before the advent of serological testing, precise diagnosis was very difficult.  In fact, the disease was often confused with other diseases, particularly in its tertiary stage.  If not treated, syphilis can cause serious effects such as damage to the heart, aorta, brain, eyes, and bones.  In some cases, these effects can be fatal.  Therefore, the serological diagnosis of syphilis is very important.




Performing Laboratory
CRMC Laboratory



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.