INTERNATIONAL MEDICAL SCHOOL

BACHELOR’S IN MEDICAL SCIENCE

SUBJECT/CODE: COMMUNICABLE DISEASES/QDA20201P

LAB REPORT 2: RAPID PLASMA REAGIN TEST
LECTURER NAME: DR MUSTAFA FADIL MOHAMMED

NAME: ILHAASHINI KRISHNAN

IC NUMBER: 010301-05-0546
ID NUMBER: 012021090323
SUBMISSION:9TH July 2023
Introduction
Syphilis is a sexually transmitted infection(STI)caused by the spirochete bacterium

Treponema pallidum. There are two different types of serologic assays for syphilis which are

nontreponemal and treponemal. The treponemal test includes enzyme-linked immunosorbent

Assays, Fluorescent Treponemal Antibody Absorption Test(FTA-ABS), and

Microhaemagglutination Assay(MHA-TP). Non Treponemal tests include Venereal Disease

Research Laboratory Test(VDRL) and Rapid Plasma Reagin Test. The rapid plasma

reagin(RPR) test is a macroscopic, non-treponemal flocculation card test used to screen for

syphilis. It works by detecting the nonspecific antibodies that our body produces while fighting

the infection. RPR test is divided into Qualitative and Quantitative. In the test, the RPR antigen

is mixed with serum or with plasma on a plastic-coated card. The RPR test measures IgM and

IgG antibodies to lipoidal material released from damaged host cells as well as to lipoprotein-

like material, and possibly cardiolipin released from the treponemas. If antibodies are present,

they combine with the lipid particles of the antigen, causing them to agglutinate. If antibodies

are not present, the test mixture is uniformly gray. Nontreponemal tests are screening tests,

very rapid, not accurate, and relatively simple, but need to be confirmed by treponemal tests.
The procedure of the rapid plasma reagin (RPR) test
1. 50 microliters of serum or plasma placed onto the RPR test card, using a safety

pipetting device.

2. Gently shake the antigen dispensing bottle to re-suspend the particles.

3. 17 microliters of antigen suspension were added to each circle containing serum or

plasma.

4. The sample was mixed in a circular motion with a mixing stick for 8 minutes.
 5. The agglutination of the sample was observed

Result

Circle 1 shows agglutination which indicates the presence of antibodies that cause

agglutination. It can be false-positive, therefore need to proceed with a treponemal test.

Circle 2 and 3 show no agglutination indicating there is to absence of antibodies. But it also

can be false-negative, therefore need to proceed with a treponemal test.

The substance is being detected in the patient sample

The RPR test searches for nonspecific treponemal antibodies to the substances given off by

cells when a syphilis infection damages them. The presence of these antibodies indicates

whether syphilis infection is present or not.

A negative reagin serological test for syphilis does not prove that the patient does not have

syphilis. Give 3 reasons that support this statement.

The false-negative reagin serological result may occur due to the infection being too recent.

The patient has not produced antibodies yet. Therefore, there is no agglutination occurs. The

sample was taken too early. The infection takes 14 to 21 days to trigger the immune response

and is found by the test.

The false-negative reagin serological result may occur Treatment is underway. If the patient

undergoes treatment also may reduce the sensitivity of antibodies towards the infection.

The false-negative reagin serological result may occur due to the patient being

immunocompromised and unable to respond. For example, if the patient had infected with

HIV, it will weaken the immune system. Therefore, the antibodies cannot respond to the

antigen. On the other hand, the disease is latent, inactive, or the patient’s body tolerates the

organism.

The differences between rapid plasma reagin test and Venereal Disease Research Laboratory

Test

The key difference between VDRL and RPR is that VDRL is a nontreponemal test that needs

a microscope to diagnose syphilis, while RPR is a nontreponemal test that does not need a

microscope to diagnose syphilis.

VDRL RPR

Definition VDRL is a nontreponemal RPR is a nontreponemal

test that diagnoses syphilis test that diagnoses syphilis

infection using a infection without using a

microscope microscope

Specimen Blood and cerebrospinal Blood

fluid

Commonness Less commonly used in More commonly used in

laboratories laboratories

Heating the specimen Serum should be heated The serum is not heated

before reaction or before reaction or

flocculation flocculation

Effectiveness VDRL is less effective than RPR is more effective than

RPR VDRL
 Advantages Cerebrospinal fluid can be RPR test can be seen by

used as a specimen the naked eye without a

microscope, and it is very

easy to use and can be

readily purchased in a kit

form

Disadvantages A microscope should be Cerebrospinal fluid cannot

used to observe the result. be used as a specimen

and not very easy to use

Conclusion

Syphilis is a sexually transmitted infection (STI) caused by the spirochete bacterium

Treponema pallidum. It can be fatal if left untreated. A rapid plasma reagin(RPR) test is a blood

test used to screen for syphilis. It works by detecting the nonspecific antibodies that produce

against Treponema antigen. This reduces the chances of complications and the spread of the

disease by an infected but unaware person. This RPR test cannot confirm syphilis and move

on to the second test which is the treponema test.

References

• Debra Stang,12TH December 2022, RPR test, Healthline, Retrieved from

https://www.healthline.com/health/rpr-test on 9th July 2023

• Jenna Fletcher on June 21, 2018, What to know about RPR testing for syphilis,

Medicalnewstoday, Retrieved from

https://www.medicalnewstoday.com/articles/322204 on 9th July 2023

• Dr.Samanthi, December 4, 2022, What is the Difference Between VDRL and RPR,

Difference Between. com, Retrieved from https://www.differencebetween.com/what-

is-the-difference-between-vdrl-and-rpr/
• Healthlabs. com,2022, Syphilis, RPR test, Retrieved from

https://www.healthlabs.com/syphilis-rpr-testing-rapid-plasma

• University of Rochester Medical Center, Rapid Plasma Reagin,2021, Retrieved from

https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&cont

entid=rapid_plasma_reagin_syphilis#:~:text=The%20rapid%20plasma%20reagin%2

0(RPR,muscle%20aches%2C%20and%20sore%20throat.