Test Id : SSB
SS-B/La Antibodies, IgG, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Evaluating patients with clinical features or at-risk for connective tissue disease, especially Sjögren syndrome.
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Connective Tissue Disease Cascade.
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.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Anti-La
Anti-SSB (Anti-Sjogren's Syndrome B)
Autoantibodies to SS-B/LA, Serum
La (Anti-SSB)
Sjogren's Syndrome
SSB (Anti-SSB)
SSB Autoantibodies
Anti-Sjogren Syndrome
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Connective Tissue Disease Cascade.
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
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
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 |
| Heat-treated | Reject |
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 with clinical features or at-risk for connective tissue disease, especially Sjögren syndrome.
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Connective Tissue Disease Cascade.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Sjogren syndrome (SjS) is a heterogeneous systemic autoimmune rheumatic disorder characterized by diverse immunologic responses to SS-A/Ro and SS-B/La antigens.(1) These immune reactivities have been implicated in the destruction of the epithelium of the exocrine glands with the demonstration of typical peri-epithelial lymphocytic infiltration that can vary from sicca syndrome to systemic disease and lymphoma.(2) The SS-A/Ro and SS-B/La system is considered as a heterogeneous antigenic complex which is made up of three different proteins (Ro52, Ro60 and La) and four small RNAs particles.(1,2) The SS-B/La antigen is a 48 kDa phosphorylated protein which can be found in the nucleus and the cytoplasm and binds to several RNA molecules.(3) SS-B/La appears to be susceptible to proteolysis and degrades into smaller but immunoreactive polypeptides.(4)
Unlike antibodies to SS-A/Ro that are present in SjS and other connective tissue diseases (CTD) [systemic lupus erythematosus, systemic sclerosis, inflammatory myopathies, overlap CTD] and primary biliary cholangitis, anti-SS-B/La antibodies are found primarily in patients with SjS.(2,5,6) In addition, SS-A/Ro antibodies may be found alone in many patients with SjS, however, anti-SS-B/La autoantibodies without SS-A/Ro has limited significant association for SjS diagnosis or phenotypic categorization.(2,6,7) Lastly, whereas testing for anti-SS-A/Ro antibodies is included in the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary SjS, evaluation of anti-SS-B/La antibodies is not required.(8)
In a recent multicenter study of more than 10,500 patients with primary SjS, anti-SSB/La antibodies were detected in 58% of anti-SSA/Ro antibody-positive cases.(9) Anti-SS-B/La antibodies are detected using a variety of solid-phase (eg, plate, bead, or membrane) immunoassays such as enzyme-linked immunosorbent assay, fluorometric enzyme-linked immunoassays, chemiluminescence immunoassays, addressable laser bead immunoassay particle-based multianalyte technology and dot or line immunoassays.(10)
For more information see Connective Tissue Disease Cascade.
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.
<1.0 U (negative
> 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 for anti-SS-B/La antibodies may be suggestive of a diagnosis of primary or secondary connective tissue disease including Sjogren syndrome if compatible autoantibody profile and clinical symptoms are present. The positive predictive value for primary Sjogren syndrome is increased with positivity for antibodies to Ro52, Ro60, and SS-B/La. Combination of anti-SSB-B/A and anti-Ro52 and/or anti-Ro60 antibodies may also be useful in the phenotypic stratification of patients with primary Sjogren syndrome.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Low levels and/or single positivity for anti-SS-B/La antibodies are likely to have limited clinical significance for the diagnosis and phenotypic stratification of patients with primary Sjogren syndrome.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Brito-Zeron P, Baldini C, Bootsma H, et al. Sjogren syndrome. Nat Rev Dis Primers. 2016;2:16047
2. Vilchez-Oya F, Balastegui Martin H, Garcia-Martinez E, Corominas H. Not all autoantibodies are clinically relevant. Classic and novel autoantibodies in Sjogren's syndrome: A critical review. Front Immunol. 2022;13:1003054
3. Bachman M, Mayet WJ, Shroder HC, Pfeifer K, Meyer zum Buschenfelde KH, Muller WE. Association of La and Ro antigens with intracellular structures in HEp-2 carcinoma cells. Proc Natl Acad Sci U S A. 1986;83(20):7770-7774
4. Habets WJ, den Brok JH, Boerbooms AM, van de Putte LB, van Venrooij WJ. Characterization of the SS-B (La) antigen in adenovirus-infected and uninfected HeLa cells. EMBO J. 1983;2(10):1625-1631
5. Deroo L, Achten H, De Boeck K, et al. The value of separate detection of anti-Ro52, anti-Ro60 and anti-SSB/La reactivities in relation to diagnosis and phenotypes in primary Sjogren's syndrome. Clin Exp Rheumatol. 2022;40(12):2310-1317
6. Baer AN, McAdams DeMarco M, Shiboski SC, et al. The SSB-positive/SSA-negative antibody profile is not associated with key phenotypic features of Sjogren's syndrome. Ann Rheum Dis. 2015;74(8):1557-1561
7. Acar-Denizli N, Horvath IF, Mandl T, et al. Systemic phenotype related to primary Sjogren's syndrome in 279 patients carrying isolated anti-La/SSB antibodies. Clin Exp Rheumatol. 2020;38 Suppl 126(4):85-94
8. Shiboski CH, Shiboski SC, Seror R, et al. 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjogren's syndrome: A consensus and data-driven methodology involving three international patient cohorts. Ann Rheum Dis. 2017;76(1):9-16
9. Brito- Zeron P, Acar-Denizlin N, Ng WF et al. How immunological profile drives clinical phenotype of primary Sjogren’s syndrome at diagnosis: analysis of 10,500 patients (Sjogren Big Data Project). Clin Exp Rheumatol. 2018;36(Suppl. 112):S102-112
10. Bossuyt X, De Langhe E, Borghi MO, Meroni PL. Understanding and interpreting antinuclear antibody tests in systemic rheumatic diseases. Nat Rev Rheumatol. 2020;16(12):715-726
Method Description
Describes how the test is performed and provides a method-specific reference
Affinity-purified SS-B antigen is coupled covalently to polystyrene microspheres, which are impregnated with fluorescent dyes to create a unique fluorescent signature. SS-B/La antibodies, if present in diluted serum, bind to the SS-B 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-SS-B/La 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, and a secondary laser reveals the level of PE fluorescence associated with each microsphere. Results are calculated by comparing the median fluorescence response for SS-B/La microspheres to a 4-point calibration curve.(Package insert: Bioplex 2200 ANA Screen. Bio-Rad Laboratories; 02/2019)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
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.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
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.
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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.
CPT codes are provided by the performing laboratory.
86235
LOINC® Information
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.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| SSB | SS-B/La Ab, IgG, S | 33613-1 |
| 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.
|
|---|---|---|
| SSB | SS-B/La Ab, IgG, S | 33613-1 |