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/PR3 Antibodies (2002068).
For evaluation of autoimmune liver disease, use in conjunction with Autoimmune Liver Disease Reflexive Panel (3002479).




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.

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, IgG
Negative 19 AU/mL or less
Equivocal 20-25 AU/mL
Positive 26 AU/mL or greater

  Serine Proteinase 3, IgG
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 MPO. Approximately 85 percent of patients with a C-ANCA pattern by IFA have antibodies specific for PR3.

Compliance Category



Specimens are screened for ANCA, MPO and PR3.  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.

Hotline History


CPT Codes

83516 x2; 86255; if reflexed, add 86256


Component Test Code* Component Chart Name LOINC
0050526 Myeloperox Antibodies, IgG 6969-0
0050527 Serine Proteinase 3, IgG 6968-2
0050811 Anti-Neutrophil Cytoplasmic Ab, IgG 29967-7
* 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
ANCA-Associated Vasculitis Profile (ANCA/MPO/PR3) with Reflex to ANCA Titer (INACTIVE as of 08/16/21: Refer to 3003745 in the August Hotline)