Ordering Recommendation

If Rheumatoid Arthritis Panel (2003277) is positive, test reflexes to Rheumatoid Factors, IgA, IgG, and IgM, which may aid in prognostication.  Rheumatoid Arthritis Panel is preferred for initial workup of suspected rheumatoid arthritis or undifferentiated inflammatory arthritides.

Mnemonic
RA PAN R
Methodology

Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Quantitative Immunoturbidimetry/Quantitative Enzyme-Linked Immunosorbent Assay

Performed

Sun-Sat

Reported

1-4 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation

Fasting specimen preferred.

Collect

Serum separator tube (SST).

Specimen Preparation

Allow serum to clot completely at room temperature before centrifuging. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.8 mL) Serum is the only acceptable specimen type for this test without a disclaimer.

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Plasma, miscellaneous body fluid, or urine. Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.

Remarks
Stability

After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)

Reference Interval
Test Number
Components
Reference Interval
0055256 Cyclic Citrullinated Peptide (CCP) Antibody, IgG
19 Units or less Negative
20-39 Units Weak positive
40-59 Units Moderate positive
60 Units or Greater Strong positive

0050465 Rheumatoid Factor 0-14 IU/mL
0051298 Rheumatoid Factors, IgA, IgG, and IgM by ELISA
Test Number
Components
Reference Interval
  Rheumatoid Factor, IgG by ELISA Refer to report
  Rheumatoid Factor, IgM by ELISA Refer to report
  Rheumatoid Factor, IgA by ELISA Refer to report

Interpretive Data

Anti-cyclic citrullinated peptide (anti-CCP), IgG antibodies are present in about 69-83 percent of patients with rheumatoid arthritis (RA) and have specificities of 93-95 percent. These autoantibodies may be present in the preclinical phase of disease, are associated with future RA development, and may predict radiographic joint destruction. Patients with weak positive results should be monitored and testing repeated.

Compliance Category

FDA

Note

If CCP IgG is 20 Units or greater and/or Rheumatoid Factor is 15 IU/mL or greater, then Rheumatoid Factor, IgG/IgM/IgA by EIA will be performed. Additional charges apply.

Hotline History
N/A
CPT Codes

86200; 86431; if reflexed, add 83516 x3

Components
Component Test Code* Component Chart Name LOINC
0050465 Rheumatoid Factor 11572-5
0055256 Cyclic Citrullinated Peptide Ab, IgG 33935-8
* 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
  • CCP and RF IgA IgG IgM
  • CCP, RF, RF isotypes
  • RA
  • RA panel reflex RF
  • RF
Rheumatoid Arthritis Panel with Reflex to Rheumatoid Factors, IgA, IgG, and IgM by ELISA