ANCA-Associated Vasculitis Profile (ANCA/MPO/PR-3) with Reflex to ANCA Titer
2006480
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 Anti-Neutrophil Cytoplasmic Antibody with Reflex to Titer and MPO/PR-3 Antibodies (2002068) or Serine Protease 3 Antibody (0050527) or Myeloperoxidase Antibody (0050526) tests.
Mnemonic
ANCA PRO
Methodology
Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Multiplex Bead Assay
Performed
Mon-Sat
Reported
2-5 days
New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
- Patient Preparation
- Collect
- 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
- Refrigerated.
- Unacceptable Conditions
- CSF, plasma, urine, or other body fluids. Contaminated, hemolyzed, or severely lipemic specimens.
- Remarks
- Stability
- After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
Reference Interval
| Test Number | Components | Reference Interval |
| Anti-Neutrophil Cytoplasmic Antibody, IgG | < 1:20: Not significant | |
| Myeloperoxidase Antibody | Negative: 19 AU/mL or less Equivocal: 20-25 AU/mL Positive: 26 AU/mL or greater | |
| Serine Protease 3 Antibody | Negative: 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).
Note
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.
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
Components
| Component Test Code* | Component Chart Name |
|---|---|
| 0050526 | Myeloperox Antibodies, IgG |
| 0050527 | Serine Protease3, IgG |
| 0050811 | Anti-Neutrophil Cytoplasmic Ab, IgG |
Cross References
- Anti-Neutrophil Cytoplasmic Antibodies Panel, IgG (Anti-Neutrophil Cytoplasmic Antibody with Reflex