Feedback
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 the ANCA reflex panel that includes a titer, and MPO and PR-3 antibodies (2002068).  
• Initial test in conjunction with autoimmune liver disease panel (2007210) for evaluation of automimmune liver disease.

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.
Submit With Order
ARUP Consult®
Disease Topics
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 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).

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.
CPT Code(s)
83516 MPO; 83516 PR-3; 86255 ANCA; if reflexed, add 86256 ANCA titer
Components
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.
Aliases
  • (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