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Treponema pallidum Ab

Alternate Name: Trep SyphSero

  | Treponema cascading reflex, Syphilis serology

SAL Code:

232

CPT:

86780

Loinc:

47236-5

Turn Around Time:

1 Day

Setup:

Daily

Department:

Diagnostic Immunology

Performing Laboratory:

Sherman Abrams Laboratory

Methodology:

Chemiluminescent Immunoassay (CLIA)

Specimen Requirements:

Primary Tube:

SST

Primary Substance:

Serum

Alternate Sample Info:

Red top tube

Temperature

Period

Stable Ambient:

7 Days

Stable Fridge:

14 Days

Stable Frozen:

1 Month

Rejection Criteria:

Grossly hemolyzed, icteric or lipemic samples as well as samples containing particulate matter or exhibiting obvious microbial contamination and improperly labeled samples.

Clinical Info:

This test is intended for the qualitative determination of total antibodies directed against Treponema pallidum in human serum. The presence of antibodies to Treponema pallidum specific antigen, in conjunction with non-treponemal laboratory tests and clinical findings may aid in the diagnosis of syphilis infection.Syphilis may be diagnosed by different serological laboratory tests, which are also useful in establishing the stage of the disease when adopted together with other clinical tests. Serological diagnosis is generally established by using two standard tests combined, non-treponemal antibody tests for screening purposes and specific treponemal antibody tests for confirmation purposes. A Negative Treponema pallidum result indicates a lack of serological evidence of T. pallidum infection (early primary syphilis cannot be excluded). Retest in 2-4 weeks if clinically warranted. An Equivocal Treponema pallidum result suggests the need for retesting. Please submit a sample within one week. An Equivocal result will also reflex to an RPR. A Positive Treponema pallidum result will reflex to an RPR

Additional Information:

Test Interpretation Guidelines:

SCENARIO 1:

T.pallidum EIA result: Nonreactive
No further test is recommended.

INTERPRETATION GUIDELINE:

No serologic evidence of infection with T. pallidum (incubating or early primary syphilis cannot be excluded).
Serology test may be falsely nonreactive in patients with immunodeficiency.
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SCENARIO 2:

T.pallidum EIA result: Reactive
Test will reflex to RPR. IF RPR is reactive, no further test is recommended.

INTERPRETATION GUIDELINE:

Syphilis, old or new. Treatment usually indicated unless previously treated.
Retreatment indicated if RPR titer has increased fourfold or more. The RPR titer is useful to follow the treatment.
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SCENARIO 3:

T.pallidum EIA result: Reactive
Test will reflex to RPR. IF RPR is nonreactive, test will reflex to TP-PA. If result of TP-PA is nonreactive:

INTERPRETATION GUIDELINE:

If this result is suspected to be a falsely reactive because of clinical history, or if the patient has never been
treated for syphilis, repeat testing in 2-4 weeks is recommended. If the result remains the same on repeat testing,
a different Treponemal test is recommended to attempt to resolve the apparent discrepancy.
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SCENARIO 4:

T.pallidum EIA result: Reactive
Test will reflex to RPR. IF RPR is nonreactive, test will reflex to TP-PA. If result of TP-PA is reactive:

INTERPRETATION GUIDELINE:

T. pallidum EIA and TP-PA remain reactive for years and do not decline with therapy. The RPR is nonreactive.
The RPR titer declines and often disappears after appropriate antibiotic therapy. The most likely explanation for
this combination is that the patient had syphilis which was previously treated.
Note: In untreated late stage syphilis, the RPR titer declines and may be absent.
Clinical correlation with history of treatment is recommended.
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Test Limitations:

This test allows screening for the presence of Treponema pallidum total antibodies. It detects both recent and past infections, but it cannot distinguish between different antibody classes.
• Detection of Treponema pallidum total antibodies may indicate recent, past or successfully treated syphilis: this test, therefore, cannot discriminate between active and treated disease and, as a consequence, may not be used for determining response to therapy.

Test Information:

Components:

Brooklyn Navy Yard
Building 292, Suite 416
63 Flushing Avenue
Brooklyn, NY 11205

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