Test Catalog

Test Id : MPO

Myeloperoxidase Antibodies, IgG, Serum

Useful For
Suggests clinical disorders or settings where the test may be helpful

Evaluating patients suspected of having immune-mediated vasculitis, especially microscopic polyangiitis (MPA), when used in conjunction with other autoantibody tests (see Cautions)

 

May be useful to follow treatment response or to monitor disease activity in patients with MPA

Method Name
A short description of the method used to perform the test

Multiplex Flow Immunoassay

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Myeloperoxidase Ab, S

Aliases
Lists additional common names for a test, as an aid in searching

ANCA (Antineutrophil Cytoplasmic Antibodies)

Anti-Myeloperoxidase Antibodies

Antibodies to Myeloperoxidase

Anticytoplasmic Autoantibodies

Antineutrophil Cytoplasmic Antibodies (ACPA)

Autoantibodies to Myeloperoxidase

Autoantibodies to Proteinase 3

Cytoplasmic Neutrophil Antibodies

Myeloperoxidase Antibodies (MPO)

Neutrophil Cytoplasmic Antibodies

Wegener's Granulomatosis

Perinuclear Antineutrophil Cytoplasmic Antibody (pANCA)

Specimen Type
Describes the specimen type validated for testing

Serum

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.5 mL

Forms

If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.35 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

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

Useful For
Suggests clinical disorders or settings where the test may be helpful

Evaluating patients suspected of having immune-mediated vasculitis, especially microscopic polyangiitis (MPA), when used in conjunction with other autoantibody tests (see Cautions)

 

May be useful to follow treatment response or to monitor disease activity in patients with MPA

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Myeloperoxidase (MPO) enzyme is found in neutrophil primary granules and monocyte lysosomes. MPO catalyzes the conversion of hydrogen peroxide to hypochlorite and hypochlorous acid. MPO is encoded by a single gene that undergoes posttranslational modification to produce the active enzyme found in leukocytes.

 

Autoantibodies to MPO (MPO antineutrophil cytoplasmic antibodies: ANCA) occur in several diseases and may be involved in the pathogenesis of vascular inflammation in patients with microscopic polyangiitis (MPA).(1,2) Patients with MPA often develop MPO ANCA and may present with azotemia secondary to glomerulonephritis (pauci-immune necrotizing glomerulonephritis). MPO ANCA are not specific for MPA, and also may be detected in patients with systemic lupus erythematosus with or without lupus nephritis, Goodpasture syndrome and Churg-Strauss syndrome. Lupus nephritis and Goodpasture syndrome, as well as Wegener granulomatosis may present with azotemia and progressive renal failure. It is not possible to distinguish among these diseases on the basis of clinical signs and symptoms; autoantibody testing may be helpful.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

<0.4 U (negative)

0.4-0.9 U (equivocal)

> or =1.0 U (positive)

Reference values apply to all ages.

Interpretation
Provides information to assist in interpretation of the test results

A positive result has a high predictive value for microscopic polyangiitis (MPA) in patients with negative test results for systemic lupus erythematosus (antinuclear antibodies) and Goodpasture syndrome (glomerular basement membrane antibody). A negative result significantly diminishes the likelihood that a patient has MPA.(3)

 

While myeloperoxidase levels often decline following successful treatment of MPA, specific guidelines for this clinical purpose are not available.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Since it is not possible to distinguish between microscopic polyangiitis (MPA) and other causes of progressive renal failure or systemic illness (eg, Wegener granulomatosis, lupus nephritis, Goodpasture syndrome), this test should be employed in conjunction with other diagnostic tests in the initial evaluation of such patients. The recommended test in this setting is VASC / Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum, which includes myeloperoxidase (MPO) antibodies, proteinase 3 (PR3) antibodies and, if indicated, antineutrophil cytoplasmic antibodies (ANCA). The test for ANCA identifies 2 types of antibodies-cytoplasmic (cANCA), which are specific for PR3 and perinuclear (pANCA), which are specific for MPO.

 

The presence of MPO is quite specific for MPA (diagnostic specificity approaches 95%); but, it is recommended that positive results obtained by EIA be confirmed by another testing method. This is best accomplished by testing for pANCA, which confirms the positive MPO result and increases the diagnostic specificity for MPA to 97%.(3) Nevertheless, positive results for MPO have been reported in patients with systemic lupus erythematosus, Goodpasture syndrome, and Churg-Strauss syndrome. Therefore, clinicians must rule out these diagnoses to maximize the specificity and positive predictive value of the MPO test result.

 

While sequential measurements of MPO may be used to follow treatment response or to monitor disease activity in patients with MPA, results should not be exclusively relied upon to assess response to treatment or disease activity.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Falk RJ, Jennette JC: Anti-neutrophil cytoplasmic autoantibodies with specificity for myeloperoxidase in patients with systemic vasculitis and idiopathic necrotizing and crescentic glomerulonephritis. N Engl J Med 1988 Jun 23;318(25):1651-1657

2. Stone JH, Hellman DB: Small and medium-vessel vasculitis. In Clinical Immunology Principles and Practice. Third edition. Edited by RR Rich, TA Fleisher, WT Shearer, et al. Mosby/Elsevier, 2007, pp 859-884

3. Russell KA, Wiegert E, Schroeder DR, et al: Detection of antineutrophil cytoplasmic antibodies under actual clinical testing conditions. Clin Immunol 2002 May;103(2):196-203

Method Description
Describes how the test is performed and provides a method-specific reference

Myeloperoxidase (MPO) antigen is covalently coupled to polystyrene microspheres that are impregnated with fluorescent dyes to create a unique fluorescent signature. MPO antibodies, if present in diluted serum, bind to the MPO antigen on the microspheres. The microspheres are washed to remove extraneous serum proteins. Phycoerythrin (PE)-conjugated antihuman IgG antibody is then added to detect IgG anti-MPO bound to the microspheres. The microspheres are washed to remove unbound conjugate, and bound conjugate is detected by laser photometry. A primary laser reveals the fluorescent signature of each microsphere to distinguish it from microspheres that are labeled with other antigens. A secondary laser reveals the level of PE fluorescence associated with each microsphere. Results are calculated by comparing the median fluorescence response for MPO microspheres to a 4-point calibration curve.(Package insert: Bio-Plex 2200 Vasculitis. Bio-Rad Laboratories, Hercules, CA 2012)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

1 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

83516

LOINC® Information

Test Id Test Order Name Order LOINC Value
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
MPO Myeloperoxidase Ab, S 48404-8
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
MPO Myeloperoxidase Ab, S 48404-8

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Create a PDF

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports