Test ID: VASC Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum
Reporting Name
ANCA Panel for Vasculitis, SUseful For
Evaluating patients suspected of having autoimmune vasculitis, both Wegener granulomatosis and microscopic polyangiitis
Clinical Information
Antineutrophil cytoplasmic antibodies (ANCA) occur in patients with autoimmune vasculitis including Wegener granulomatosis (WG), microscopic polyangiitis (MPA), or organ-limited variants thereof such as pauci-immune necrotizing glomerulonephritis.(1) ANCA react with enzymes in the cytoplasmic granules of human neutrophils including proteinase 3 (PR3), myeloperoxidase (MPO), elastase, and cathepsin G.
Autoantibodies to PR3 occur in patients with WG (both classical WG and WG with limited end-organ involvement) and produce a characteristic pattern of granular cytoplasmic fluorescence on ethanol-fixed neutrophils called the cANCA pattern. Antibodies to MPO occur predominately in patients with MPA and produce a pattern of perinuclear cytoplasmic fluorescence on ethanol-fixed neutrophils called the pANCA pattern.
Autoantibodies to PR3 and MPO can also be detected by EIA methods and are referred to as PR3 ANCA and MPO ANCA, respectively.
Interpretation
Positive results for proteinase 3 (PR3) antineutrophil cytoplasmic antibodies (ANCA) and cANCA or pANCA are consistent with the diagnosis of Wegener granulomatosis (WG), either systemic WG with respiratory and renal involvement or limited WG with more restricted end-organ involvement.
Positive results for MPO ANCA and pANCA are consistent with the diagnosis of autoimmune vasculitis including microscopic polyangiitis (MPA) or pauci-immune necrotizing glomerulonephritis.
A positive result for PR3 ANCA or MPO ANCA has been shown to detect 89% of patients with active WG or MPA (with or without renal involvement) with fewer than 1% false-positive results in patients with other diseases.(1)
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
MPO | Myeloperoxidase Ab, S | Yes | Yes |
PR3 | Proteinase 3 Ab (PR3), S | Yes | Yes |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
ANCA | Cytoplasmic Neutrophilic Ab, S | Yes | No |
Testing Algorithm
If myeloperoxidase antibody or proteinase 3 antibody is ≥0.4 U, then cytoplasmic neutrophilic antibodies will be performed at an additional charge.
Report Available
3 to 5 daysDay(s) Performed
Monday through Saturday
Clinical Reference
1. Russell KA, Wiegert E, Schroeder DR, et al: Detection of anti-neutrophil cytoplasmic antibodies under actual clinical testing conditions. Clin Immunol 2002 May;103(2):196-203
2. Specks U, Homburger HA, DeRemee RA: Implications of cANCA testing for the classifications of Wegner's Granulomatosis: performance of different detection systems. Adv Exp Med Biol 1993;336:65-70
Method Name
Multiplex Flow Immunoassay
Specimen Type
SerumOrdering Guidance
For monitoring disease activity, we advise physicians to order ANCA / Cytoplasmic Neutrophil Antibodies, Serum or MPO / Myeloperoxidase Antibodies, IgG, Serum.
Specimen Required
Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 1 mL
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 21 days | |
Frozen | 21 days |
Reference Values
MYELOPEROXIDASE ANTIBODIES, IgG
<0.4 U (negative)
0.4-0.9 U (equivocal)
≥1.0 U (positive)
Reference values apply to all ages.
PROTEINASE 3 ANTIBODIES, IgG
<0.4 U (negative)
0.4-0.9 U (equivocal)
≥1.0 U (positive)
Reference values apply to all ages.
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
83516 x 2
86036 (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
VASC | ANCA Panel for Vasculitis, S | 90230-4 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
MPO | Myeloperoxidase Ab, S | 48404-8 |
PR3 | Proteinase 3 Ab (PR3), S | 74106-6 |
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-General Request (T239)
-Renal Diagnostics Test Request (T830)
mml-Behavioral, mml-Cerebrovascular, mml-Epilepsy, mml-Headache, mml-Demyelinating-Diseases, mml-Neuroimmunology, mml-Neuromuscular, mml-Autonomic, mml-Pediatric, mml-Spinal-Cord, mml-Neuro-ophthalmology