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Test ID VASC Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum

Secondary ID

83012

Useful For

Evaluating patients suspected of having autoimmune vasculitis, both Wegener’s granulomatosis and microscopic polyangiitis

Profile Information

Test ID Reporting Name Available Separately Always Performed
MPO Myeloperoxidase Ab, S Yes Yes
PR3 Proteinase 3 Ab (PR3), S Yes Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ANCA Cytoplasmic Neutrophilic Ab, S Yes No

Testing Algorithm

If myeloperoxidase antibody or proteinase 3 antibody is ≥0.4 U, then cytoplasmic neutrophilic antibodies will be performed at an additional charge.

Method Name

MPO, PR3: Multiplex Flow Immunoassay

ANCA: Indirect Immunofluorescence

Reporting Name

ANCA Panel for Vasculitis, S

Specimen Type

Serum

Container/Tube: 

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL

Forms: If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

Neurology Test Request Form-General (T732) (http://www.mayomedicallaboratories.com/it-mmfiles/neurology-request-form.pdf)

General Request Form (T239) (http://www.mayomedicallaboratories.com/it-mmfiles/general-request-form.pdf)

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

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

Clinical Information

Antineutrophil cytoplasmic antibodies (ANCA) 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) ANCA react with enzymes in the cytoplasmic granules of human neutrophils including proteinase 3 (PR3), myeloperoxidase (MPO), elastase, and cathepsin G.

 

Autoantibodies 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.

 

Autoantibodies to PR3 and MPO can also be detected by EIA methods and are referred to as PR3 ANCA and MPO ANCA, respectively.

Reference Values

MYELOPEROXIDASE ANTIBODIES, IgG

<0.4 U (negative)

0.4-0.9 U (equivocal)

≥1.0 U (positive) 

Reference values apply to all ages.

 

PROTEINASE 3 ANTIBODIES, IgG

<0.4 U (negative)

0.4-0.9 U (equivocal)

≥1.0 U (positive) 

Reference values apply to all ages.

Cautions

Sequential measurements of titers of antineutrophil cytoplasmic antibodies (cANCA) are useful to monitor the response to treatment in patients with Wegener's granulomatosis (WG). While titers often decrease following successful treatment, the results cannot be relied upon in all cases to determine the response to therapy. In individual patients, the titers of cANCA may not correlate well with response to treatment. The results of proteinase 3 (PR3) ANCA (an autoantibody with a cANCA pattern) by EIA have not been shown to be useful for monitoring disease activity. Accordingly, for monitoring disease activity we advise physicians to order ANCA / Cytoplasmic Neutrophil Antibodies, Serum or MPO / Myeloperoxidase Antibodies, IgG, Serum (the ANCA vasculitis test panel is not appropriate for monitoring disease activity).

 

The ANCA vasculitis test panel cannot be relied upon exclusively to establish the diagnosis of autoimmune vasculitis (WG or microscopic polyangiitis: MPA). Some patients with WG or MPA may not have a measurable titer of antibodies detected by this panel of tests. Some of these patients have antibodies to other neutrophil antigens not included in the panel, eg, neutrophil elastase.

Day(s) Performed

Monday through Saturday; 4 p.m.

Report Available

3 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test has been cleared or approved by the U.S. 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-PR3

83516-MPO

86255-Cytoplasmic neutrophil antibodies screen (if appropriate)

86256-Cytoplasmic neutrophil antibodies titer (if appropriate)

NY State Approved

Yes