Rheumatoid Arthritis Panel with Reflex to Rheumatoid Factors, IgA, IgG, and IgM by ELISA
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
Methodology
Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Quantitative Immunoturbidimetry
Performed
Sun-Sat
Reported
1-4 days
New York DOH Approval Status
Specimen Required
Fasting specimen preferred.
Serum separator tube (SST).
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.
Refrigerated.
Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.
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 |
|
||||||||||||
0050465 | Rheumatoid Factor | 0-14 IU/mL | ||||||||||||
0051298 | Rheumatoid Factors, IgA, IgG, and IgM by ELISA |
|
||||||||||||
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.
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
Hotline History
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 |
Aliases
- Carbamylated Protein IgG
- CarP IgG
- CCP and RF IgA IgG IgM
- CCP, RF, RF isotypes
- RA
- RA panel reflex RF
- RF