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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. For patients with a history of vasculitis, refer to Anti-Neutrophil Cytoplasmic Antibody with Reflex to Titer and MPO/PR-3 Antibodies (2002068).
For evaluation of autoimmune liver disease, use in conjunction with Autoimmune Liver Disease Evaluation with Reflex to Smooth Muscle Antibody (SMA), IgG by IFA (2007210).

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, IgG
Negative19 AU/mL or less
Equivocal20-25 AU/mL
Positive26 AU/mL or greater

 Serine Protease3, IgG
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 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