Rapid Plasma Reagin (RPR), Reflex to Titer
CPT Code(s):
86592
Turnaround Time:
8 hours
Specimen Requirements
Preferred Specimen:
Serum
Minimum Volume:
1.0 mL
Transport Container:
Serum Separator Tube (SST) or Red Top Tube
Transport Temperature:
Room Temperature
Collection Instructions:
Allow blood to clot completely prior to centrifugation. Separate serum from cells within 45 minutes of collection.
Rejection Criteria:
Citrate, Fluoride,Sodium Heparin specimen; gross hemolysis; lipemia; improper labeling
Stability Criteria
Room Temperature:
5 days
Refrigerated:
5 days
Frozen:
7 days
Clinical Significance
The Rapid Plasma Reagin (RPR) test has specific clinical significance and diagnostic use in the detection of syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum. RPR is a non-treponemal serological test used to screen for the presence of antibodies against the bacterium in the patient's blood.
The clinical significance and diagnostic use of RPR include:
1. Syphilis Screening: RPR is widely used as a screening tool for syphilis infection. It detects the presence of antibodies, specifically immunoglobulin M (IgM) and immunoglobulin G (IgG), which are produced by the body in response to the infection. A positive RPR indicates the need for further confirmatory testing to confirm the diagnosis of syphilis.
2. Diagnosis and Staging of Syphilis: RPR is also used for the diagnosis and staging of syphilis. Serial RPR tests may be performed to monitor the progression or regression of the infection. The test results, along with clinical evaluation and other tests, help determine the stage of syphilis (primary, secondary, latent, or tertiary) and guide appropriate treatment decisions.
3. Follow-up Monitoring: After treatment for syphilis, RPR is used for follow-up monitoring to assess the effectiveness of treatment. Serial RPR tests are performed to evaluate the decline in antibody titers, which indicates successful treatment. A sustained decrease or seroreversion (becoming non-reactive) of RPR suggests a satisfactory response to therapy.
4. Screening in High-Risk Populations: RPR is utilized in screening programs targeting high-risk populations, such as sexually active individuals, pregnant women, and individuals with a history of sexually transmitted infections. Timely detection and treatment of syphilis in these populations can prevent transmission to sexual partners and reduce the risk of congenital syphilis in infants.
It is important to note that RPR is a screening and should be followed by confirmatorys, such as the Treponemal-specific test (e.g., Treponema pallidum particle agglutination assay, fluorescent treponemal antibody absorption test), to confirm the diagnosis of syphilis. Additionally, false-positive results can occur with RPR, and further evaluation is required to distinguish true positives from false positives.
In summary, the Rapid Plasma Reagin (RPR) test plays a vital role in the screening, diagnosis, staging, and follow-up monitoring of syphilis infection. It serves as an important tool in identifying individuals who require further testing and treatment, allowing for timely intervention and prevention of the complications associated with syphilis.