Lupus Panel 3 with ANA, IFA with Reflex to Titer and Pattern

Message

If the ANA Screen (IFA) is positive, ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).

SRHC Clients:

1 large red top tube (no gel)
Centrifuge and remove serum from red cells within 1 hour of collection, then freeze sample for transport
If unable to centrifuge and freeze sample, send patient to SRHC Laboratory for collection due to stability requirements
Transport sample FROZEN to SRHC laboratory

Test Code

LAB4440417

Quest Code

19881

Alias/See Also

Antinuclear Profile IV
Autoimmune Profile IV
Autoimmune Profile

CPT Codes
86038, 86225, 86235 (x5), 86160 (x2), 86162

Includes

ANA Screen, IFA, with Reflex to Titer and Pattern
DNA (ds) Antibody
Sjogren's Antibodies (SS-A, SS-B)
Sm Antibody
RNP Antibody
Chromatin (Nucleosomal) Antibody
Complement Component C3c and C4c
Complement, Total (CH50)

If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).

Preferred Specimen

3.5 mL serum (2.5 mL minimum)

Minimum Volume

0.5 mL (x4)

Instructions

Must be frozen due to the CH50 component

Transport Temperature

Frozen

Specimen Stability

Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 7 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Samples received at room temperture or refrigerated

Methodology
See individual tests

Setup Schedule

Set up and Report available: See individual tests

Reference Range

See Laboratory Report

Clinical Significance

This panel can be helpful in the diagnosis and management of systemic lupus erythematosus (SLE). The panel simultaneously tests for antinuclear antibodies (ANAs) with an immunofluorescence assay (IFA), performed on human epithelial type 2 (HEp-2) cells, as well as 6 specific autoantibodies associated with SLE and 3 biomarkers associated with disease activity. For specimens with positive ANA IFA results, reflex testing for ANA titer and pattern is performed.

The ANA testing has high sensitivity (97%) for SLE but limited specificity (34%) [1]. Anti-dsDNA and anti-Sm antibodies are less sensitive but more specific; tests for both antibodies are included in classification criteria for SLE [2]. Anti-chromatin antibodies have relatively high sensitivity and specificity. Although antibodies to SSA and SSB may also be seen in Sjogren Syndrome and anti-RNP is a marker of mixed connective tissue disease, these antibodies are also frequently present in SLE and may be helpful.

The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.

References
1. Petri M, et al. Arthritis Rheum. 2012;64(8):2677-2686.
2. Aringer M, et al. Ann Rheum Dis. 2019;78(9):1151-1159.

Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Dr
Chantilly, VA 20153

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.