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ANCA Vasculitides
Test Code36733
CPT Codes
86021 (x2)
Includes
Myeloperoxidase Antibody, Proteinase-3 Antibody
Preferred Specimen
1 mL serum
Minimum Volume
0.3 mL
Transport Container
Plastic screw-cap vial
Transport Temperature
Room temperature
Specimen Stability
Room temperature: 7 days
Refrigerated: 14 days
Frozen: 30 days
Refrigerated: 14 days
Frozen: 30 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis
Methodology
Immunoassay (IA)
Setup Schedule
Set up: Tues-Sat a.m.; Report available: Next day
Reference Range
Myeloperoxidase Antibody
Proteinase-3 Antibody
| <1.0 AI | No antibody detected | |||
| ≥1.0 AI | Antibody detected | |||
| <1.0 AI | No antibody detected | |||
| ≥1.0 AI | Antibody detected | |||
Clinical Significance
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 vascular diseases will generally have either a C-ANCA pattern or P-ANCA pattern, and give positive results in specific tests for PR-3 or 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.
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 vascular diseases will generally have either a C-ANCA pattern or P-ANCA pattern, and give positive results in specific tests for PR-3 or 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.
