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HelpTest ID VASC Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum
Ordering Guidance
For monitoring disease activity, we advise physicians to order ANCA / Cytoplasmic Neutrophil Antibodies, Serum or MPO / Myeloperoxidase Antibodies, IgG, Serum.
Necessary Information
The Test must contain information in the following fields in LTC QA. 1/20/2025
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-General Request (T239)
-Renal Diagnostics Test Request (T830)
Secondary ID
83012Useful For
Evaluating patients suspected of having autoimmune vasculitis, both Wegener 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 |
| MSPP | Mosquito Spp., IgE | 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.
The Test must contain information in the following fields in LTC QA. 1/20/2025
Method Name
Multiplex Flow Immunoassay
Reporting Name
ANCA Panel for Vasculitis, SSpecimen Type
SerumSpecimen 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 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 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
Report Available
3 to 5 days 01/20/2025Performing 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 x 2
86036 (if appropriate)
99633 01/20/2025