Treponema pallidum (VDRL) CSF with Reflex to Titer

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Brief Description

Specimens will be screened for the detection of reagin antibodies.  Reagin antibodies are non-treponemal antibodies produced by the body's defense mechanism in response to an infection with Treponema pallidum.  If the VDRL is reactive, a quantitative titer will be done. 

Laboratory Unit

Immunology

Methodology

Micro-Flocculation

Specimen Collection

One 6 mL red top vacutainer tube or a sterile tube not containing any coagulants. Refer to the Additional Information section for details regarding VDRL testing.

Storage/Transport

1 mL CSF at 2-8° C
Store specimens at refrigerator temperature (2-8° C) prior to shipment.
Specimens should be sent daily or next working day.
Transport in MSPHL shipping containers at room temperature.

Acceptable Specimen
Type(s)

CSF(cerebrospinal fluid)



Test Request Form(s)

Immunology Test Request Form

Possible Results

Reactive
Non-Reactive
Unsatisfactory

Reference Range

VDRL:  Non-Reactive
VDRL Titer:  < 1:1
TP-PA:  Reactive

Unacceptable Conditions

Plasma Specimens
Severely Hemolyzed Specimens
No Name on Specimen
Name on Specimen Does Not Match Name on Request Form
Quantity Not Sufficient

Interfering Substances

Hemolysis and bacterial contamination

Result Reported

1 day after specimen receipt

Fees

N/A

CPT Codes

86592 VDRL; if reflexed, add 86593 VDRL titer

LOINC/SNOMED Codes

VDRL:  5290-2
VDRL Titer:  31146-4

Additional Information

Biological false positive reactions occur occasionally with the carbon antigen (RPR) from individuals with a history of drug abuse, or with diseases such as lupus erythematosus, malaria, vaccinia, mononucleosis, leprosy, viral pneumonia, and after smallpox vaccinations.  Pinta, yaws, bejel, and other treponemal diseases produce positive reactions in this test.  A final diagnosis should not be made on the result of a single test, but should be based on a correlation of test results with other clinical findings.  

A serum specimen needs to accompany the VDRL - CSF.  Only if the TP-PA is reactive, will the VDRL be performed.  If the specimen is from a patient 2 years of age or younger, the VDRL will be performed even if the TP-PA is non-reactive.