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Interpretive Handbook

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Test 81357 :
RNP Antibodies, IgG, Serum

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

RNP (also called nRNP and U1RNP) is a small nuclear ribonucleoprotein that contains 3 protein autoantigens (called A, C, and 68 kD). Sera that contain RNP antibodies react predominately with the A and 68 kD autoantigens. Antibodies to RNP occur in approximately 50% of patients with lupus erythematosus (LE) and in patients with other connective tissue diseases, notably mixed connective tissue disease (MCTD). MCTD is characterized by high levels of RNP antibodies without detectable Sm or double-stranded DNA (dsDNA) antibodies. MCTD resembles LE but is not accompanied by renal involvement.(1,2)

 

RNP is 1 of 4 autoantigens commonly referred to as extractable nuclear antigens (ENA). The other ENAs are SS-A/Ro, SS-B/La, and Sm. Each ENA is composed of 1 or more proteins associated with small nuclear RNA species (snRNP) ranging in size from 80 to approximately 350 nucleotides. Antibodies to ENAs are common in patients with connective tissue diseases (systemic rheumatic diseases) including LE, MCTD, Sjogren's syndrome, scleroderma (systemic sclerosis), and polymyositis/dermatomyositis.

 

See Connective Tissue Disease Cascade (CTDC) in Special Instructions and Optimized Laboratory Testing for Connective Tissue Diseases in Primary Care: The Mayo Connective Tissue Diseases Cascade in Publications.

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

Evaluating patients with signs and symptoms of a connective tissue disease in whom the test for antinuclear antibodies is positive

Interpretation Provides information to assist in interpretation of the test results

A positive result for RNP antibodies is consistent with a connective tissue disease. Although strongly associated with connective tissue diseases, RNP antibodies are not considered a "marker" for any particular disease except in the following situation: when found in isolation (ie, dsDNA antibodies and Sm antibodies are not detectable), a positive result for RNP antibodies is consistent with the diagnosis of mixed connective tissue disease.

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

Testing for RNP antibodies is not useful in patients without demonstrable antinuclear antibodies.

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.

Clinical References Provides recommendations for further in-depth reading of a clinical nature

1. Homburger H, Larsen S: Detection of specific antibodies. In Clinical Immunology: Principles and Practice. First edition. Edited by R Rich, T Fleisher, B Schwartz, et al. St. Louis, Mosby-Year Book, 1996, pp 2096-2109

2. Kotzin B, West S: Systemic lupus erythematosus. In Clinical Immunology Principles and Practice. Second edition. Edited by R Rich, T Fleisher, W Shearer, et al. St. Louis, Mosby-Year Book, 2001, pp 60.1-60.24


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