Test Catalog

Test Id : ANCA

Cytoplasmic Neutrophil Antibodies, Serum

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

Evaluating patients suspected of having antineutrophil cytoplasmic antibody-associated vasculitis (granulomatosis with polyangiitis and microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis)

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

Indirect Immunofluorescence

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

Cytoplasmic Neutrophilic Ab, S

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

ACPA (Anti-Neutrophil Cytoplasmic Antibodies)

ANCA (Antineutrophil Cytoplasmic Antibodies)

ANCA (Wegener's)

Anti-Neutrophil Cytoplasmic Ab Test

Anti-Neutrophil Cytoplasmic Antibodies

Anticytoplasmic Antibody

Anticytoplasmic Autoantibodies

Antineutrophil Cytoplasmic Antibodies (ACPA)

Autoantibodies to Proteinase 3

c-ANCA (Anti-Neutrophil Cytoplasmic Antibodies)

cANCA (Antineutrophil Cytoplasmic Antibodies)

Cytoplasmic Antibody

Cytoplasmic Neutrophil Antibodies

MPO (Myeloperoxidase Antibodies)

Myeloperoxidase Antibodies (MPO)

Neutrophil Cytoplasmic Antibodies


pANCA (Perinuclear Antineutrophil Cytoplasmic Antibody)

Perinuclear anti-neutrophil cytoplasmic antibody (pANCA)

Perinuclear Antineutrophil Cytoplasmic Antibody (pANCA)

PR3 (Proteinase 3) Antineutrophil Cytoplasmic Antibodies

Proteinase 3 (PR3) Antineutrophil Cytoplasmic Antibodies

Wegener's Disease

Wegener's Granulomatosis

Specimen Type
Describes the specimen type validated for testing


Additional Testing Requirements

When used for diagnosis, it is recommended that specific tests for proteinase 3, antineutrophil cytoplasmic antibodies (ANCA), and myeloperoxidase ANCA be performed in addition to testing for cytoplasmic ANCA and perinuclear ANCA.(1) This panel of tests is available; order VASC / Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, 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: 0.8 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.


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

0.4 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 specimen 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 suspected of having antineutrophil cytoplasmic antibody-associated vasculitis (granulomatosis with polyangiitis and microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis)

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

Antineutrophil cytoplasmic antibodies (ANCA) can occur in patients with small blood vessel vasculitis, including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), or eosinophilic granulomatosis with polyangiitis (EGPA), collectively referred to as ANCA-associated vasculitis (AAV).(2) Detection of ANCA is a well-established diagnostic test for the evaluation of patients suspected of having AAV.(3) ANCA react with enzymes in the cytoplasmic granules of human neutrophils including proteinase 3 (PR3), myeloperoxidase (MPO), elastase, and cathepsin G amongst others. Of these, PR3-ANCA and MPO-ANCA are the best characterized in AAV. Antibodies to PR3-ANCA occur in patients with GPA and produce a characteristic pattern of granular cytoplasmic fluorescence on ethanol-fixed neutrophils called the cytoplasmic ANCA pattern. Antibodies to MPO-ANCA occur predominately in patients with MPA and produce a pattern of perinuclear cytoplasmic fluorescence on ethanol-fixed neutrophils called the perinuclear ANCA (pANCA) pattern.(4) EGPA may be pANCA positive with reactivity to MPO-ANCA or negative for ANCA. The pANCA pattern may also be observed in patients with inflammatory bowel disease, predominantly ulcerative colitis, usually in the absence of detectable MPO-ANCA reactivity.

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.


If positive for antineutrophil cytoplasmic antibodies, results are titered.

Provides information to assist in interpretation of the test results

Positive results for antineutrophil cytoplasmic antibodies (ANCA) demonstrate two main patterns namely, cytoplasmic and perinuclear in a compendium of small vessel vasculitis collectively referred to as ANCA-associated vasculitis (AAV) that includes granulomatosis with polyangiitis, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis.


Negative ANCA results do not rule out a diagnosis of AAV or irritable bowel disease.

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

Current recommendations suggest that testing for antineutrophil cytoplasmic antibodies (ANCA) by indirect immunofluorescence assay should not be relied upon exclusively to establish the diagnosis of granulomatosis with polyangiitis (GPA), microscopic polyangiitis, or eosinophilic granulomatosis with polyangiitis (see Interpretation).


Due to their lack of diagnostic specificities, all positive ANCA results must be confirmed using solid-phase immunoassays using proteinase 3-ANCA for cytoplasmic ANCA (cANCA) and myeloperoxidase-ANCA for perinuclear ANCA.


Changes in titer of cANCA should not be relied upon exclusively to either judge the disease activity of patients with GPA or determine the response to treatment. A decreasing titer of cANCA may lag behind the induction of clinical remission by several weeks in a patient with GPA, and a detectable titer of cANCA may persist indefinitely despite induction of a stable clinical remission of disease. Conversely, a slight increase in the titer of cANCA should not be interpreted to mean an exacerbation of disease without further clinical and laboratory evidence of disease progression.

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

1.Savige J, Gillis D, Benson E, et al: International consensus statement on testing and reporting of antineutrophil cytoplasmic antibodies (ANCA). Am J Clin Pathol. 1999 Apr:111(4);507-513

2. Kitching AR, Anders HJ, Basu N, et al: ANCA-associated vasculitis. Nat Rev Dis Primers. 2020 Aug;6(1);71

3. Ramponi G, Folci M, De Santis M, et al: The biology, pathogenetic role, clinical implications, and open issues of serum anti-neutrophil cytoplasmic antibodies. Autoimmun Rev. 2021 Mar;20(3):102759

4. Guchelaar NAD, Waling MM, Adhin AA, et al: The value of anti-neutrophil cytoplasmic antibodies (ANCA) testing for the diagnosis of ANCA-associated vasculitis, a systematic review and meta-analysis. Autoimmun Rev. 2021 Jan:20(1);102716

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

Antibodies to cytoplasmic antigens in neutrophils are detected by an indirect immunofluorescent technique. Commercial and in-house slides prepared from human neutrophils are used as a substrate. IgG antibodies in serum specimens are detected after incubation of serum with the commercial and in-house slides by the addition of a fluorescein isothiocyante-labeled antihuman IgG reagent. All patient specimens are initially screened at 1:4 and 1:8 dilutions.(Package insert: NOVA Lite ANCA. Inova Diagnostics, Inc; 05/2018)

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.

3 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


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 was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

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.

86036 x2

86037-Titer (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
ANCA Cytoplasmic Neutrophilic Ab, S 87427-1
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.
3114 c-ANCA 14277-8
3119 p-ANCA 17357-5

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