Anti-Neutrophil Cytoplasmic Antibody with Reflex to Titer and MPO/PR3 Antibodies
Ordering Recommendation

Preferred reflex panel for managing patients with a known diagnosis of vasculitis. May be assistive in evaluating suspected vasculitis. For the workup of suspected vasculitis, the preferred panel is ANCA-Associated Vasculitis Profile (ANCA/MPO/PR3) with Reflex to ANCA Titer (2006480).

Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Multiplex Bead Assay
2-5 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Serum separator tube. 
Specimen Preparation
Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL) 
Storage/Transport Temperature
Unacceptable Conditions
CSF, plasma, urine, or other body fluids. Contaminated, hemolyzed, or severely lipemic specimens. 
After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles) 
Reference Interval
Test Number
Reference Interval
Anti-Neutrophil Cytoplasmic Antibody, IgG< 1:20: Not significant
0050526Myeloperoxidase (MPO) Antibody
Negative19 AU/mL or less
Equivocal20-25 AU/mL
Positive26 AU/mL or greater

0050527Serine Proteinase 3 (PR3) Antibody
Negative19 AU/mL or less
Equivocal20-25 AU/mL
Positive26 AU/mL or greater

Interpretive Data
Neutrophil cytoplasmic antibodies (C-ANCA = granular cytoplasmic staining, P-ANCA = perinuclear staining) are found in the serum of over 90% of patients with certain necrotizing systemic vasculitides, and usually in less than 5% of patients with collagen vascular disease or arthritis. Approximately 90% of patients with a P-ANCA pattern by IFA have antibodies specific for MPO. Approximately 85% of patients with a C-ANCA pattern by IFA have antibodies specific for PR3.

Specimens are screened by IFA on ethanol-fixed neutrophils, formalin-fixed neutrophils, and HEp-2 slides that allow differentiation of C- and P-ANCA patterns.

If screen is positive, then titer and MPO/PR3 antibodies will be added to aid in antibody determination. Additional charges apply.
Hotline History
View Hotline History
CPT Code(s)
86255; if reflexed, add 83516 x2; 86256
Component Test Code*Component Chart NameLOINC
0050811Anti-Neutrophil Cytoplasmic Ab, IgG29967-7
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please view this test within the Laboratory Test Directory found at
  • (Perinuclear Antineutrophil Cytoplasmic Antibody
  • ACPA
  • ANCA
  • ANCA Panel, IgG
  • Anti-Neutrophil Cytoplasmic Ab Test
  • Anti-Neutrophil Cytoplasmic Antibodies Panel, IgG
  • Anticytoplasmic Antibody
  • Antineutrophil Cytoplasmic Antibodies (ACPA)
  • Autoantibodies to Proteinase 3
  • c ANCA (Anti-Neutrophil Cytoplasmic Antibody with Reflex to Titer & MPO/PR3 Antibodies)
  • c-ANCA
  • Cytoplasmic Neutrophil Antibodies
  • MPO)
  • p ANCA
  • P-ANCA
  • pANCA
  • PR3
  • Proteinase 3