Quick Review Cards for Medical Laboratory Science

Nontreponemal Tests for Syphilis Immunology Review 397

Method

Detects

Antigen

Positive reaction

Specimen(s)

Reactivity during
disease

False positives

Other

VDRL

Flocculation

Reagin (ab against cardiolipin that is in serum of pts with syphilis)

Cardiolipin

Microscopic clumps

Inactivated serum, CSF

May be neg in primary stage. Titers usually peak during secondary

or early late stages. Titers in late stage, even when untreated.

More rapid decline with treatment. Becomes nonreactive in

1–2 yr following successful treatment.

Biologic false pos with infectious mononucleosis (IM), infectious

hepatitis, malaria, leprosy, lupus erythematosus, rheumatoid

arthritis, advanced age, pregnancy. Reactive in other treponemal

infections such as yaws & pinta.

Screening test. Reactives should be confirmed by treponemal test.

Replaced by RPR for serum. Still performed on CSF for Dx of neu-

rosyphilis.

RPR

Flocculation.

Reagin.

Cardiolipin with charcoal.

Macroscopic agglutination.

Serum (inactivation not required),

plasma.

Same as VDRL.

Same as VDRL.

Used for screening & treatment

monitoring. Screening test.

Reactives should be confirmed

by treponemal test.