Evaluating patients with signs and symptoms of a connective tissue disease in whom the test for antinuclear antibodies is positive, especially those with signs and symptoms consistent with Sjogren syndrome or lupus erythematosus
This test is not useful in patients without demonstrable antinuclear antibodies.
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
SSA | SS-A/Ro Ab, IgG, S | Yes | Yes |
SSB | SS-B/La Ab, IgG, S | Yes | Yes |
For more information see Connective Tissue Disease Cascade.
Multiplex Flow Immunoassay
Anti-La
Anti-Ro
Anti-Sjogren's Syndrome
Anti-SSA (Anti-Sjogren's Syndrome A)
Anti-SSB (Anti-Sjogren's Syndrome B)
Autoantibodies to SS-B/LA, Serum
Autoantibodies to SSA (Ro)
Autoantibodies to SSB (La)
La (Anti-SSB)
Ro (Anti-SSA)
Ro Autoantibodies
Sjogren's Syndrome
SSA (Anti-SSA)
SSA Autoantibodies
SSB (Anti-SSB)
SSB Autoantibodies
For more information see Connective Tissue Disease Cascade.
Serum
Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 0.5 mL
0.35 mL
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 21 days | |
Frozen | 21 days |
Evaluating patients with signs and symptoms of a connective tissue disease in whom the test for antinuclear antibodies is positive, especially those with signs and symptoms consistent with Sjogren syndrome or lupus erythematosus
This test is not useful in patients without demonstrable antinuclear antibodies.
For more information see Connective Tissue Disease Cascade.
Sjogren syndrome (SS)A (Ro), SSB (La), ribonucleoprotein (RNP), and Smith (Sm) proteins are autoantigens commonly referred to as extractable nuclear antigens (ENA). Antibodies to ENA are common in patients with connective tissue diseases (systemic rheumatic diseases).
SSA or Ro is composed of protein antigens of 52 kDa and 60 kDa combined with cytoplasmic RNA species. SSA antibodies occur in patients with several different connective tissue diseases including Sjogren syndrome, an autoimmune disease that involves primarily the salivary and lachrymal glands (up to 90% of cases); systemic lupus erythematosus (SLE) (40%-60% of cases); and rheumatoid arthritis. SSA antibodies are associated with childhood SLE, neonatal SLE, and with congenital heart block in infants born to mothers with SLE.(1,2) SSA antibodies have also been reported to be associated with features of extraglandular inflammation in patients with SLE including vasculitis, purpura, cytopenias, and adenopathy.
SSB or La is composed of a 48-kDa protein combined with RNA species. SSB antibodies are found primarily in patients with Sjogren syndrome or SLE, where they occur with frequencies of approximately 60% and 15%, respectively.(1,2) SSB antibodies occur only infrequently in the absence of SSA antibodies.
For more information see Connective Tissue Disease Cascade.
SS-A/Ro ANTIBODIES, IgG
<1.0 U (negative)
> or =1.0 U (positive)
Reference values apply to all ages
SS-B/La ANTIBODIES, IgG
<1.0 U (negative
> or =1.0 (positive)
Reference values apply to all ages.
A positive result for SSA (Ro) or SSB (La) antibodies is consistent with connective tissue disease, including Sjogren syndrome, lupus erythematosus (LE), or rheumatoid arthritis.
A positive result for SSA antibodies in a woman with LE prior to delivery indicates an increased risk of congenital heart block in the neonate.
No significant cautionary statements
1. Homburger H, Larsen S: Detection of specific antibodies. In: Rich R, Fleisher T, Schwartz B, et al, eds. Clinical Immunology: Principles and Practice. Mosby-Year Book; 1996:2096-2109
2. Kotzin B, West S: Systemic lupus erythematosus. In: Rich R, Fleisher T, Shearer E, et al, eds. Clinical Immunology Principles and Practice. 2nd ed. Mosby-Year Book; 2001:60.1-60.24
3. Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018
Recombinant SS-A/Ro 52 kD, affinity-purified SS-A/Ro 60 kD, and affinity-purified SS-B antigen are coupled covalently to polystyrene microspheres that are impregnated with fluorescent dyes to create a unique fluorescent signature. SS-A/Ro antibodies, if present in diluted serum, bind to the SS-A/Ro antigens on the microspheres, and SS-B/La antibodies, if present, 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-A/Ro or 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-A/Ro and SS-B/La microspheres to a 4-point calibration curve.(Package insert: Bioplex 2200 ANA Screen. Bio-Rad Laboratories, Hercules, CA 11/2011)
Monday through Saturday
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.
86235 x 2
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
SSAB | SSA/SSB | 87555-9 |
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.
|
---|---|---|
SSA | SS-A/Ro Ab, IgG, S | 33610-7 |
SSB | SS-B/La Ab, IgG, S | 33613-1 |