Test Id : RIB
Ribosome P Antibodies, IgG, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
As an adjunct in the diagnostic evaluation of patients with systemic lupus erythematosus (SLE)
May be useful in the phenotypic stratification of SLE patients at risk for neuropsychiatric SLE, lupus nephritis and/or hepatitis
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-Ribosome P Antibodies
Ribosomal P Antibodies
Ribosome Antibody
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
As an adjunct in the diagnostic evaluation of patients with systemic lupus erythematosus (SLE)
May be useful in the phenotypic stratification of SLE patients at risk for neuropsychiatric SLE, lupus nephritis and/or hepatitis
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
Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease that affects multiple organ systems with diverse clinical presentations. The disease is characterized by a diversity of antinuclear antibody (ANA) specificities associated with positivity of nuclear and/or cytoplasmic patterns using the HEp-2 substrate by indirect immunofluorescence assay (IFA).(1,2) Of the ANA-specific autoantibodies, only anti-dsDNA and anti-Smith antibodies associated with the Hep-2 substrate IFA nuclear patterns are required in contemporary classification criteria for SLE.(3,4) Detection of non-criteria SLE autoantibodies and their associated profiles are fundamental in the clinical management of patients as these antibodies provide important clues for diagnosis, phenotypic categorization, and disease activity, as well as potential therapeutic targets.(5) For example, these autoantibodies may be involved in the inflammatory and immune complex formation causing damage in multiple end-organs such as kidney, skin, and central nervous system (CNS).
Anti-ribosomal P protein (anti-Rib-P, anti-P) antibodies were initially described in the 1980s and subsequently reported to recognize three specific ribosomal proteins (P0, P1 and P2, of 38, 19 and 17 kDa molecular weight, respectively) located in the large ribosome's subunit.(6). A 2015 systematic review and meta-analysis of published studies reported significant association with malar rash, oral ulcer, photosensitivity and anti-dsDNA antibody positivity.(7) However, the associations with neuropsychiatric SLE, hepatic damage, serum anti-Smith and anti-cardiolipin antibodies were observed more frequently in anti-Rib-P positive patients than in negative patients. In a more recent meta-analysis, significant associations were noted for CNS involvement and psychosis, and lupus hepatitis with heterogeneity between studies for lupus nephritis.(6) In a recent large single center study, anti-Rib-P antibody positivity was associated with a higher proportion of neurological involvement (p <0.05) at baseline.(8) In the same study, antibody-positive patients for anti-Rib-P antibodies were more likely to accumulate neuropsychiatric damage (adjusted HR = 3.8, 95% CI 2.7-57), p <0.001). The variable clinical associations between positivity for anti-Rib-P antibodies and the reported SLE manifestations in these and other studies may be due to demographic and clinical heterogeneity of the cohorts and different formulations of the immunoassays and methods for detecting antibodies.(6,9)
Anti-ribosomal antibodies can be detected and quantified using a variety solid-phase immunoassays in the clinical laboratory. The use of different antigenic combinations and antigens from different sources limit commutability between testing methods.(6)
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
As an adjunct in the diagnostic evaluation of patients with systemic lupus erythematosus (SLE)
May be useful in the phenotypic stratification of SLE patients at risk for neuropsychiatric SLE, lupus nephritis and/or hepatitis
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Most patients with systemic lupus erythematosus (SLE) do not have detectable levels of antibodies to ribosome P protein.
Positivity of anti-ribosomal p antibody alone should not be relied upon to establish the diagnosis or to rule out the diagnosis in a patient with signs and symptoms compatible with SLE.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Damoiseaux J, Andrade LEC, Carballo OG, et al. Clinical relevance of HEp-2 indirect immunofluorescent patterns: the International Consensus on ANA patterns (ICAP) perspective. Ann Rheum Dis. 2019;78(7):879-889
2. Bossuyt X, De Langhe E, Borghi MO, Meroni PL. Understanding and interpreting antinuclear antibody tests in systemic rheumatic diseases. Nat Rev Rheumatol. 2020;16:715-726
3. Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64:2677-2686
4. Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis. 2019;78:1151-1159
5. Irure-Ventura J, López-Hoyos M. Disease criteria of systemic lupus erythematosus (SLE); the potential role of non-criteria autoantibodies. J Transl Autoimmun. 2022;5:100143
6. Choi MY, FitzPatrick RD, Buhler K, Mahler M, Fritzler MJ. A review and meta-analysis of anti-ribosomal P autoantibodies in systemic lupus erythematosus. Autoimmun Rev. 2020;19:102463
7. Shi ZR, Cao CX, Tan GZ, Wang L. The association of serum anti-ribosomal P antibody with clinical and serological disorders in systemic lupus erythematosus: a systematic review and meta-analysis. Lupus. 2015;24:588-596
8. Ding Y, Zhao J, Qian J, et al. The role of anti-ribosomal P autoantibodies in the prediction of neuropsychiatric damage in systemic lupus erythematosus based on CSTAR cohort (XIV). Clin Rheumatol. 2022;41:1371-1379
9. Emerson JS, Gruenewald SM, Gomes L, Lin MW, Swaminathan S. The conundrum of neuropsychiatric systemic lupus erythematosus: Current and novel approaches to diagnosis. Front Neurol. 2023;14:1111769
Method Description
Describes how the test is performed and provides a method-specific reference
Affinity-purified ribosome P antigens are coupled covalently to polystyrene microspheres, which are impregnated with fluorescent dyes to create a unique fluorescent signature. Ribosome P antibodies, if present in diluted serum, bind to ribosome P 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-ribosome P antibodies 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 ribosome P 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 :
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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.
83516
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 |
|---|---|---|
| RIB | Ribosome P Ab, IgG, S | 53892-6 |
| 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.
|
|---|---|---|
| RIB | Ribosome P Ab, IgG, S | 53892-6 |