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.

No compliance statements are in use for this test.


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