The Reiter Protein Complement-Fixation (RPCF) Test

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Abstract
Four hundred seventy Reiter protein complement-fixation (RPCF) tests were performed on specimens of serum from 215 patients who had reactive cardiolipin tests for syphilis. Treponema pallidum immobilization (TPI) tests were also performed with specimens from these patients. Results of the 2 tests were in agreement with specimens of serum from 165 (76.6%) of these patients. Specimens from 26 patients were reactive with the TPI test alone, whereas serums of 24 patients were reactive with the RPCF antigen and nonreactive with the TPI tests. A review of the history and physical examination on 64 patients suggests that the RPCF test is as specific and sensitive as the TPI test. The activity in all but 3 of the syphilitic patients had progressed beyond the secondary stage of infection. A reactive RPCF test indicates that the patient has or has had syphilis. A nonreactive RPCF test should not be the basis for excluding this possibility, and clinical evidence may indicate the advisability of a TPI test. Nonreactive results with RPCF and also the TPI tests are not suitable for excluding the possibility of a syphilitic infection some time in the past. A single nonreactive RPCF is of no value. The first RPCF test was nonreactive, but repeat tests performed on the same specimen were reactive on serum specimens from 30% of the 114 patients who had reactive RPCF reports. All specimens that fail to react with the RPCF antigen should be tested a second time. Results of tests on anticomplementary serums were generally satisfactory after the serum had been treated by means of the modified Sachs method. The Kolmer antigen was more satisfactory than the RPCF antigen for testing spinal fluids.

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