Test ID: VASC
Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Evaluating patients suspected of having autoimmune vasculitis, both Wegener’s 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 test(s) that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ANCA | Cytoplasmic Neutrophilic Ab, S | Yes | No |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
If myeloperoxidase (MPO) antibody or proteinase 3 (PR3) antibody is >=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
MPO/80389, PR3/82965: Multiplex Flow Immunoassay
ANCA/9441: Indirect Immunofluorescence
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
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
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Specimen Volume: 1 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross reject |
| Lipemia | Mild OK; Gross reject |
| Icterus | Mild OK; Gross OK |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 21 days |
| Frozen | 21 days |
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's 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's 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's granulomatosis (WG). While titers often decrease following successful treatment, the results can not 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/9441 Cytoplasmic Neutrophil Antibodies, Serum or MPO/80389 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 Provides recommendations for further 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
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Saturday; 4 p.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
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 The location of the laboratory that performs the test
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's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
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 Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
83516-PR3
83516-MPO
86255-Cytoplasmic neutrophil antibodies screen (if appropriate)
86256-Cytoplasmic neutrophil antibodies titer (if appropriate)
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| MPO | Myeloperoxidase Ab, S | 6969-0 |
| PR3 | Proteinase 3 Ab (PR3), S | 6968-2 |
External
link
PDF
document
Excel
document
Word
document