Ordering Recommendation

If anticyclic citrullinated peptide (anti-CCP) IgG or rheumatoid factor is positive, rheumatoid factors, IgA, IgG, and IgM will be performed, which may aid in prognostication. Rheumatoid Arthritis Panel (3004055) is preferred for initial workup of suspected rheumatoid arthritis or undifferentiated inflammatory arthritides.

Mnemonic

RA PANEL R

Methodology

Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Quantitative Immunoturbidimetry

Performed

Sun-Sat

Reported

1-4 days

New York DOH Approval Status

Specimens from New York clients will be sent out to a New York DOH approved laboratory, if possible.

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

Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.

Remarks
Stability

After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 month (should not be thawed more than once)

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

3003992 Carbamylated Protein (CarP) Antibody, IgG 0-19 Units

Interpretive Data

Anticyclic 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. Anticarbamylated protein (anti-CarP) IgG antibodies are present in about 34-53 percent of patients with RA, have specificities of greater than 90 percent and can occur in RA patients seronegative for both rheumatoid factor and anti-CCP. Anti-CCP and anti-CarP 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.

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Analyte Specific Reagent (ASR)

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; 83516 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
3003993 Carbamylated Protein Antibody, IgG
* 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

  • Carbamylated Protein IgG
  • CarP IgG
  • 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