ANCA-Associated Vasculitis Profile (ANCA/MPO/PR-3) with Reflex to ANCA Titer
Ordering Recommendation
Preferred reflex panel for the workup of suspected vasculitis. Panel detects ANCA, MPO, and PR-3 antibodies.
For patients with a history of vasculitis, refer to the ANCA panel that reflexes to a titer, testing for MPO and PR-3 antibodies (2002068).  Individual antibody tests are available; refer to Serine Protease 3 Antibody (0050527) or Myeloperoxidase Antibody (0050526) tests.
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
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 Ab, IgG< 1:20: Not significant
 Myeloperox Antibodies, IgGNegative: 19 AU/mL or less
Equivocal: 20-25 AU/mL
Positive: 26 AU/mL or greater
 Serine Protease3, IgGNegative: 19 AU/mL or less
Equivocal: 20-25 AU/mL
Positive: 26 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 percent of patients with certain necrotizing systemic vasculitides, and usually in less than 5 percent of patients with collagen vascular disease or arthritis. Approximately 90 percent of patients with a P-ANCA pattern by IFA have antibodies specific for myeloperoxidase (MPO). Approximately 85 percent of patients with a C-ANCA pattern by IFA have antibodies specific for serine proteinase 3 (PR-3).

Specimens are screened for ANCA, MPO and PR-3.  If the ANCA screen detects antibodies at a 1:20 dilution or greater, then a titer to end point will be added. Additional charges apply.

ANCA IFA is simultaneously tested on ethanol- and formalin-fixed slides to allow differentiation of C- and P-ANCA patterns.
CPT Code(s)
83516 MPO; 83516 PR-3; 86255 ANCA; if reflexed, add 86256 ANCA titer
Component Test Code*Component Chart NameLOINC
0050526Myeloperox Antibodies, IgG6969-0
0050527Serine Protease3, IgG6968-2
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 click the sidebar link to access the Interface Map.
  • (Perinuclear Antineutrophil Cytoplasmic Antibody
  • ANCA
  • ANCA Reflex
  • Anti-Neutrophil Cytoplasmic Ab Test
  • Anti-Neutrophil Cytoplasmic Antibodies Panel, IgG
  • Anticytoplasmic Antibody
  • Antineutrophil Cytoplasmic Antibodies (ACPA)
  • Autoantibodies to Proteinase 3
  • c-ANCA
  • Cytoplasmic Neutrophil Antibodies
  • MPO)
  • P-ANCA
  • pANCA
  • PR3
  • Proteinase 3