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HelpTest ID ANCA Cytoplasmic Neutrophil Antibodies, Serum
Useful For
Antineutrophil cytoplasmic antibodies (cANCA and pANCA):
-Evaluating patients suspected of having autoimmune vasculitis (both Wegener granulomatosis [WG] and microscopic polyangiitis)
cANCA titer:
-May be useful for monitoring treatment response in patients with WG (systemic or organ-limited disease); increasing titer suggests relapse of disease, while a decreasing titer suggests successful treatment
When used for diagnosis it is recommended that specific tests for proteinase 3 (PR3) ANCA and myeloperoxidase (MPO) ANCA be performed in addition to testing for cANCA and pANCA.(2) This panel of tests is available by ordering the VASC / Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum.
Method Name
Indirect Immunofluorescence
Reporting Name
Cytoplasmic Neutrophilic Ab, SSpecimen Type
SerumContainer/Tube:
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 0.5 mL
Forms: If not ordering electronically, complete, print, and send a General Request Form (T239) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/general-request-form.pdf).
Specimen Minimum Volume
0.35 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 14 days |
| Frozen | 14 days |
Clinical Information
Antineutrophil cytoplasmic antibodies (ANCA) can occur in patients with autoimmune vasculitis including Wegener's granulomatosis (WG), microscopic polyangiitis (MPA), or organ-limited variants thereof such as pauci-immune necrotizing glomerulonephritis.(1) Detection of ANCA is a well-established diagnostic test for the evaluation of patients suspected of having autoimmune vasculitis. ANCA react with enzymes in the cytoplasmic granules of human neutrophils including proteinase 3 (PR3), myeloperoxidase (MPO), elastase, and cathepsin G. Antibodies to PR3 occur in patients with WG (both classical WG and WG with limited end-organ involvement) and produce a characteristic pattern of granular cytoplasmic fluorescence on ethanol-fixed neutrophils called the cANCA pattern. Antibodies to MPO occur predominately in patients with MPA and produce a pattern of perinuclear cytoplasmic fluorescence on ethanol-fixed neutrophils called the pANCA pattern.
Reference Values
Negative
If positive for cANCA, results are titered.
Cautions
Current recommendations suggest that testing for antineutrophil cytoplasmic antibodies (ANCA) by immunofluorescence assay should not be relied upon exclusively to establish the diagnosis of Wegener's granulomatosis (WG) or microscopic polyangiitis (MPA) (see Interpretation).
Results for cANCA testing are titered if positive (1:4, 8, 16, 32, etc.). If positive for pANCA, results are reported as positive. Changes in titer of cANCA should not be relied upon exclusively to judge the disease activity of patients with WG or to determine the response to treatment. A decreasing titer of cANCA may lag behind the induction of clinical remission by several weeks in a patient with WG and, a detectable titer of cANCA may persist indefinitely despite induction of a stable clinical remission of disease. Conversely, a slight increase in the titer of cANCA should not be interpreted to mean an exacerbation of disease without further clinical and laboratory evidence of disease progression.
The presence of an antinuclear antibody may mimic a pANCA on ethanol-fixed neutrophils.
Day(s) Performed
Monday through Saturday; 11 a.m.
Report Available
2 daysPerforming Laboratory
Mayo Medical Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
86255-Screen
86256-Titer (if appropriate)