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Test Code SYPHGM Syphilis IgG IgM w/ Reflex [LAB5650]

Test Method

Chemiluminescent immunoassay (sandwich principle); Roche cobas Pro

Performance

Specimens are typically completed the same day once received at the laboratory.

STAT requests are typically completed within 2 hour once received by the laboratory. 

Useful For

Syphilis is caused by the intracellular gram‑negative spirochete bacterium Treponema pallidum (TP) subspecies pallidum. Syphilis is mainly transmitted sexually, but also can be transmitted from mother to fetus during pregnancy or birth.  Typically, the symptoms start with a painless ulcer at the site of entry to the body (primary syphilis) followed by a widespread rash as the bacteria disseminate (secondary syphilis). A lengthy latent (asymptomatic) period follows. Eventually, tertiary syphilis ensues, characterized by the development of granulomatous dermal lesions, neurosyphilis, and/or cardiovascular syphilis (which can be fatal).

The immune response to T. pallidum is the main driver of lesion development. The antibody response is directed not only against antigens specific to T. pallidum (treponemal antibodies) but also against antigens that are not specific to T. pallidum (non‑treponemal antibodies), for example, antigens released during the cellular damage caused by the organism. Therefore, non-treponemal and treponemal tests exist for the diagnosis of syphilis.

Non‑treponemal tests use antigens comprising lecithin, cholesterol, and purified cardiolipin to detect antibodies against cardiolipin, which are present in many syphilis patients. Treponemal tests detect antibodies directed against T. pallidum proteins. A positive treponemal antibody test result indicates prior exposure to syphilis. Non‑treponemal assays are useful for monitoring the progression of disease and response to therapy. Both tests are necessary as an aid of the diagnosis.

Reference Values

Nonreactive

 

Reactive results will reflex to RPR testing. 

If treponema antibody and RPR results are discordent and no history of previous TPPA testing, specimen will be forwarded to Mayo for TPPA testing

Performing Laboratory

UnityPoint The Finley Hospital

Specimen Requirements

  1. Serum (Red/Gold) is the specimen of choice. Gel tubes are acceptable.
  2. EDTA (Purple) and Lithium heparin plasma (Green) are also acceptable specimen types. 
  3. It is recommended that the serum be separated from contact with cells within 2 hours from time of collection.
  4. Syphilis Antibody specimens are stable for 7 days at 20-25°C, 14 days at 2-8°C, and 12 months at -20°C.