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Performing Laboratory
| Memorial Hospital- Virology Laboratory | 304-388-9618 |
| Mayo Medical Laboratories | 1-800-533-1710 |
Test Profile
| Classic cytoplasmic cANCA | Myeloperoxidase antibodies (IgG) |
| Perinuclear pANCA | Proteinase 3 antibodies (IgG) |
Specimen Requirements
Serum-Plain Red Top Tube
Draw 7 ml (minimum 4 mL) blood
Allow sample to clot naturally before centrifugation
Centrifuge and remove serum within 8 hours of collection
Transport refrigerated or ambient.
Specimen Rejection
- Improperly labeled, collected, stored, and transported
- Quantity not sufficient
- Hemolyzed serum
- Serum subject to repeat freeze thaw cycles
Storage and Stability
| Refrigerate 2-8oC or Frozen | 5 days |
Reference Values
See individual test
Methodology
ANCA is performed by indirect immunofluorescence at Charleston Area Medical Center Laboratory
PR3 and MPO are performed by enzyme immunoassay at Mayo Medical Laboratory
Days Test Set Up and Turnaround
ANCA component performed in Virology Monday, Wednesday, Friday
MPO and PR3 referred to Mayo with a 2-3 day turn around time except weekends.
CPT Coding
See individual test
Additional Information
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. 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.
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.
Sequential measurements of titers of antineutrophil cytoplasmic antibodies (cANCA) are useful to monitor the response to treatment in patients with Wegener's granulomatosis (WG).