ANCA Screen with Reflex to ANCA Titer

ANSCR

If ANCA Screen is positive, then C-ANCA Titer and/or P-ANCA Titer, and/or atypical P-ANCA Titer will be performed at an additional charge (CPT code(s): 86037 for each titer performed).

Specimen Type: Serum

Collection Container/Type

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Plastic screw-cap vial

Room temperature

Room temperature: 7 days

Refrigerated: 14 days

Frozen: 30 days

Set up: Mon-Sat p.m.; Report available: 3-5 days

Testing for anti-neutrophil cytoplasmic antibodies (P-ANCA and or C-ANCA) has been found to be useful in establishing the diagnosis of suspected vascular diseases (e.g., crescentic glomerulonephritis, microscopic polyarteritis and churg-strauss syndrome), bowel disease (Crohn's Disease, ulcerative colitis, primary sclerosing cholangitis, and autoimmune hepatitis) as well as with other autoimmune diseases (drug-induced lupus, SLE, Felty's Syndrome).
ANCA has classically been divided into C-ANCA and P-ANCA depending on the immunofluorescent pattern observed. More recently the specific antigens responsible for these patterns have been described and isolated. The antigen that gives the C-ANCA pattern is Proteinase-3 (PR-3). Multiple antigens are responsible for P-ANCA pattern, the principle antigen being Myeloperoxidase (MPO).
Patients with bowel disease have been shown to have antibodies that give a P-ANCA or C-ANCA pattern. These antibodies however may not be directed towards MPO. Patients with drug induced lupus, etc, often present with a P-ANCA pattern that is associated with antibodies against MPO.