Test Catalog

Test Id : VASC

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Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum

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Overview

Test Catalog

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

Evaluating patients suspected of having autoimmune vasculitis, both Wegener granulomatosis and microscopic polyangiitis

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
MPO Myeloperoxidase Ab, S Yes Yes
PR3 Proteinase 3 Ab (PR3), S Yes Yes

Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test Id Reporting Name Available Separately Always Performed
ANCA Cytoplasmic Neutrophilic Ab, S Yes No

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If myeloperoxidase antibody or proteinase 3 antibody is > or =0.4 U, then cytoplasmic neutrophilic antibodies will be performed at an additional charge.

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

ANCA Panel for Vasculitis, S

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

ACPA (Antineutrophil Cytoplasmic Antibodies)

ANCA (Antineutrophil Cytoplasmic Antibodies)

ANCA Panel

Antibodies to Myeloperoxidase

Anticytoplasmic Autoantibodies

Antineutrophil Cytoplasmic Antibodies (ACPA)

Autoantibodies to Myeloperoxidase

Autoantibodies to Proteinase 3

Autoimmune Vasculitis

cANCA (Antineutrophil Cytoplasmic Antibodies)

Cytoplasmic Neutrophil Antibodies

Microscopic Polyangiitis (MPA)

MPO (Myeloperoxidase Antibodies)

Myeloperoxidase Antibodies (MPO)

Neutrophil Cytoplasmic Antibodies

pANCA (Perinuclear Antineutrophil Cytoplasmic Antibody)

Pauci-Immune Necrotizing Glomerulonephritis

Perinuclear Antineutrophil Cytoplasmic Antibody (pANCA)

PR3 (Proteinase 3) Antineutrophil Cytoplasmic Antibodies

Proteinase 3 (PR3) Antineutrophil Cytoplasmic Antibodies

Vasculitis Panel

Wegener's Granulomatosis

33185-VASC

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If myeloperoxidase antibody or proteinase 3 antibody is > or =0.4 U, then cytoplasmic neutrophilic antibodies will be performed at an additional charge.

Specimen Type
Describes the specimen type validated for testing

Serum

Ordering Guidance

For monitoring disease activity, we advise physicians to order ANCA / Cytoplasmic Neutrophil Antibodies, Serum or MPO / Myeloperoxidase Antibodies, IgG, 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: 1 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Renal Diagnostics Test Request (T830)

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.

0.5 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 autoimmune vasculitis, both Wegener granulomatosis and microscopic polyangiitis

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If myeloperoxidase antibody or proteinase 3 antibody is > or =0.4 U, then cytoplasmic neutrophilic antibodies will be performed at an additional charge.

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

Antineutrophil cytoplasmic antibodies (ANCA) occur in patients with autoimmune vasculitis including Wegener granulomatosis (WG), microscopic polyangiitis (MPA), or organ-limited variants thereof such as pauci-immune necrotizing glomerulonephritis.(1) ANCA react with enzymes in the cytoplasmic granules of human neutrophils including proteinase 3 (PR3), myeloperoxidase (MPO), elastase, and cathepsin G.

 

Autoantibodies to PR3 occur in patients with WG (both classical WG and WG with limited end-organ involvement) and produce a characteristic pattern of granular cytoplasmic fluorescence on ethanol-fixed neutrophils called the cANCA pattern. Antibodies to MPO occur predominately in patients with MPA and produce a pattern of perinuclear cytoplasmic fluorescence on ethanol-fixed neutrophils called the pANCA pattern.

 

Autoantibodies to PR3 and MPO can also be detected by EIA methods and are referred to as PR3 ANCA and MPO ANCA, respectively.

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.

MYELOPEROXIDASE ANTIBODIES, IgG

<0.4 U (negative)

0.4-0.9 U (equivocal)

> or =1.0 U (positive) 

Reference values apply to all ages.

 

PROTEINASE 3 ANTIBODIES, IgG

<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

Positive results for proteinase 3 (PR3) antineutrophil cytoplasmic antibodies (ANCA) and cANCA or pANCA are consistent with the diagnosis of Wegener granulomatosis (WG), either systemic WG with respiratory and renal involvement or limited WG with more restricted end-organ involvement.

 

Positive results for MPO ANCA and pANCA are consistent with the diagnosis of autoimmune vasculitis including microscopic polyangiitis (MPA) or pauci-immune necrotizing glomerulonephritis.

 

A positive result for PR3 ANCA or MPO ANCA has been shown to detect 89% of patients with active WG or MPA (with or without renal involvement) with fewer than 1% false-positive results in patients with other diseases.(1)

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

Sequential measurements of titers of antineutrophil cytoplasmic antibodies (cANCA) are useful to monitor the response to treatment in patients with Wegener granulomatosis (WG). While titers often decrease following successful treatment, the results cannot be relied upon in all cases to determine the response to therapy. In individual patients, the titers of cANCA may not correlate well with response to treatment. The results of proteinase 3 (PR3) ANCA (an autoantibody with a cANCA pattern) by EIA have not been shown to be useful for monitoring disease activity. Accordingly, for monitoring disease activity we advise physicians to order ANCA / Cytoplasmic Neutrophil Antibodies, Serum or MPO / Myeloperoxidase Antibodies, IgG, Serum (the ANCA vasculitis test panel is not appropriate for monitoring disease activity).

 

The ANCA vasculitis test panel cannot be relied upon exclusively to establish the diagnosis of autoimmune vasculitis (WG or microscopic polyangiitis: MPA). Some patients with WG or MPA may not have a measurable titer of antibodies detected by this panel of tests. Some of these patients have antibodies to other neutrophil antigens not included in the panel (eg, neutrophil elastase).

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

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

2. Specks U, Homburger HA, DeRemee RA: Implications of cANCA testing for the classifications of Wegner's Granulomatosis: performance of different detection systems. Adv Exp Med Biol 1993;336:65-70

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

See Individual Unit Codes

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.

3 to 5 days

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

See Individual Unit Codes

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 account representative. 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 x 2

86036 (if appropriate)

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
VASC ANCA Panel for Vasculitis, S 90230-4
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
PR3 Proteinase 3 Ab (PR3), S 74106-6

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 | 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