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Test ID PR3 Proteinase 3 Antibodies, IgG, Serum


Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Forms

If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

Secondary ID

82965

Useful For

Evaluating patients suspected of having Wegener granulomatosis (WG)

 

Distinguishing between WG and other forms of vasculitis, in conjunction with:

-MPO / Myeloperoxidase Antibodies, IgG, Serum

-ANCA / Cytoplasmic Neutrophil Antibodies, Serum (may be obtained as VASC / Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum)

 

May be useful to follow treatment response or to monitor disease activity in patients with myeloperoxidase antibodies

Method Name

Multiplex Flow Immunoassay

Reporting Name

Proteinase 3 Ab (PR3), S

Specimen Type

Serum

Specimen Minimum Volume

0.35 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 21 days
  Frozen  21 days

Clinical Information

Proteinase 3 (PR3) antigen is a 29-kD serine protease that exists as a protein triplet in human neutrophils.

 

Wegener granulomatosis (WG) is an autoimmune vasculitis that affects the kidneys and lungs, as well as other organs. Patients with WG develop autoantibodies to the PR3 antigen of myeloid lysosomes (PR3 antineutrophil cytoplasmic antibodies [PR3 ANCA]).(1)

 

Since it is often impossible to distinguish between WG and other forms of vasculitis on the basis of clinical signs and symptoms, tests for PR3 ANCA should be employed with other serologic tests in the initial diagnostic evaluation of patients with clinical features of vasculitis (eg, VASC / Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum).

Reference Values

<0.4 U (negative)

0.4-0.9 U (equivocal)

≥1.0 U (positive)

Reference values apply to all ages.

Cautions

While the presence of proteinase 3 antineutrophil cytoplasmic antibodies (PR3 ANCA) is highly specific for Wegener granulomatosis (WG), it is recommended that positive test results obtained by immunoassay be confirmed by another testing method.(4) This is best accomplished by testing for cytoplasmic ANCA (cANCA) and perinuclear ANCA (pANCA) by indirect immunofluorescence microscopy (ANCA / Cytoplasmic Neutrophil Antibodies, Serum). Alternately, VASC / Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum includes tests for PR3 ANCA, myeloperoxidase antibodies, and, if indicated, cANCA and pANCA. This panel is recommended for the initial diagnostic evaluation of patients clinically suspected of having systemic vasculitis. The simultaneous presence of PR3 ANCA and cANCA has a specificity greater than 99% for WG.(3)

Day(s) Performed

Monday through Saturday

Report Available

Same day/1 to 3 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83516

NY State Approved

Yes