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VDRL (RPR)

Reproductive
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Report in 12Hrs

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No Fasting Required

Details

Non-treponemal serological tests used to screen for syphilis

₹109₹220

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VDRL (RPR) Test Information Guide

  • Why is it done?
    • Screening test to detect syphilis infection caused by the bacterium Treponema pallidum
    • Routine screening during prenatal visits to prevent congenital syphilis in newborns
    • Evaluation of patients with symptoms suggestive of syphilis (rash, genital ulcers, fever, lymphadenopathy)
    • Blood bank screening prior to blood transfusions and organ donations
    • Monitoring treatment efficacy and patient response to syphilis therapy
    • Required testing for individuals with HIV/AIDS as part of routine care
    • Contact tracing and evaluation of sexual partners of confirmed syphilis cases
    • Evaluation for neurosyphilis and CNS involvement
  • Normal Range
    • Normal (Negative) Result: Non-reactive or negative   Indicates no detectable antibodies against syphilis
    • Abnormal (Positive) Result: Reactive or positive   Indicates presence of antibodies against syphilis
    • Titer Measurement: Results expressed as titers (dilutions) such as 1:1, 1:2, 1:4, 1:8, 1:16, 1:32, etc.   Higher titers generally indicate higher antibody concentration
    • Weakly Reactive: A result between clearly negative and positive, may require confirmation
    • Units: VDRL and RPR results are reported qualitatively (reactive/non-reactive) or quantitatively as titers
  • Interpretation
    • Non-Reactive Result: Suggests no current or past syphilis infection; however, may be negative during window period (first few weeks after infection before antibodies develop)
    • Reactive Result: Indicates syphilis antibodies detected; requires confirmation with treponemal test (FTA-ABS, TP-PA, or EIA)   Does not differentiate between active and past infection
    • High Titer (≥1:16): Suggests active or recent syphilis infection
    • Low Titer (<1:8): May indicate latent syphilis, treated infection, or false positive
    • Four-fold Rise in Titer: Between two tests performed weeks apart indicates active infection or reinfection
    • False Positives: Can occur with autoimmune diseases (SLE, antiphospholipid syndrome), chronic infections, malignancies, pregnancy, recent vaccinations, or advanced liver disease
    • Biological False Positives: Persistent (>6 months) or transient (<6 months) elevations without true syphilis
    • Post-Treatment: Titers typically decline after successful treatment; rapid plasma reagin may become non-reactive within 1-2 years
  • Associated Organs
    • Primary Organ Systems: Integumentary (skin), genitourinary, cardiovascular, nervous system, liver, and lymphatic system
    • Primary Syphilis: Genital chancre (ulcer), localized lymphadenopathy, typically occurring 3-90 days post-infection
    • Secondary Syphilis: Disseminated rash (including palms and soles), fever, systemic lymphadenopathy, mucous patches, condyloma lata
    • Tertiary Syphilis: Cardiovascular involvement (aortitis, aortic regurgitation), gummas (granulomatous lesions), neurosyphilis
    • Neurosyphilis: Central nervous system involvement including general paresis of the insane (GPI), tabes dorsalis, meningitis
    • Congenital Syphilis: Intrauterine transmission resulting in hepatosplenomegaly, jaundice, rash, skeletal abnormalities, CNS involvement, and developmental delays
    • Ocular Syphilis: Uveitis, anterior chamber inflammation, chorioretinitis affecting vision
    • Otosyphilis: Hearing loss, vertigo, tinnitus from eighth cranial nerve involvement
  • Follow-up Tests
    • Confirmatory Treponemal Tests (required if VDRL/RPR positive):   • Fluorescent Treponemal Antibody Absorption (FTA-ABS)   • Treponema pallidum Particle Agglutination (TP-PA)   • Enzyme Immunoassay (EIA)   • Chemiluminescence Immunoassay (CIA)
    • Cerebrospinal Fluid (CSF) Examination: If neurosyphilis suspected, including VDRL on CSF, cell count, protein, glucose
    • Dark-Field Microscopy: Direct visualization of Treponema pallidum from chancre exudate in primary syphilis
    • Direct Fluorescent Antibody Test: Identification of spirochetes in lesion exudates
    • Serial VDRL/RPR Testing: At 3, 6, 12, and 24 months post-treatment to monitor response to therapy
    • HIV Testing: Recommended for all syphilis-positive patients due to increased risk of coinfection
    • Hepatitis B and C Testing: Recommended due to similar transmission routes
    • Neuroimaging: MRI or CT if neurological symptoms present to evaluate CNS involvement
    • Audiometry: If hearing loss or otosyphilis suspected
    • Ophthalmologic Examination: If visual symptoms or ocular syphilis suspected
    • Partner Testing and Contact Tracing: Sexual partners should be evaluated and treated empirically
  • Fasting Required?
    • Fasting Required: No
    • Food and Beverage: Eating and drinking normally before the test does not affect VDRL/RPR results
    • Medications: No need to discontinue routine medications; inform phlebotomist of all current medications
    • Sample Collection: Simple blood draw requiring venipuncture, typically 5 mL of blood in a serum separator tube
    • Timing Considerations: Test can be performed at any time of day; optimal timing is when antibodies are present (after symptoms or known exposure)
    • Window Period: If recent possible exposure (<3 weeks), test may be falsely negative; repeat testing after 4-6 weeks recommended
    • Special Instructions: Inform healthcare provider of pregnancy, current infections, recent vaccinations, or autoimmune diseases

How our test process works!

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