Anti-Neutrophil Cytoplasmic Ab (ANCA)

Tube Type

Test ID   LAB458
EPIC Order
   Anti-neutrophilic Cytoplasmic Antibody (ANCA)
CPT Code(s)   88347, 83516x2
Group/Individual Test   Group
Laboratory   Clinical Immunology
Tube Station   30
Specimen Routine: 3 mL blood/Gold SST tube
Availability Routine: 3 times per week (Mon, Wed, Fri)
  STAT: Stat requests require Immunology Director approval and a Nephrology consult.
Turnaround Time   1-7 Days
Reference Range Normal: negative
Comments
  • All specimens submitted for ANCA testing are assessed for IgG ANCA antibodies by immunofluorescence assay (IFA; NOVA LiteTM ANCA IFA) using ethanol-fixed neutrophils, formalin-fixed neutrophil slides, and ELISA using purified MPO (INOVA QUANTA LiteTM MPO) and PR3 (INOVA QUANTA
    LiteTM PR3) proteins. 
  • ANCA IFA results are reported as Negative, Positive (along with the corresponding fluorescence pattern detected:  perinuclear P ANCA, cytoplasmic C-ANCA, atypical ANCA) or Indeterminate.    ANA positive samples may cause a P-ANCA staining pattern, because ethanol-fixed human neutrophils are known to contain multiple primary granule antigens such as elastase, lactoferrin, capthepsin G, cationic protein 57 and possibly other yet unidentified neutrophil antigens, samples appearing as cANCA or pANCA positive may not always test positive for specific PR3 or MPO antibodies by ELISA.
  • Results of the MPO and PR3 ELISA tests are reported in arbitrary units with the following interpretations:
<20 Units= Negative
21-30 Units= Low Positive
>30 Units= Positive
  • STAT ANCA testing is available (only with Nephrology consult) using the MPO and PR3 ELISA assays only.
 

Reviewed by J. Carr on November 04, 2025

UNC Hospitals
McLendon Clinical Laboratories
101 Manning Drive
Chapel Hill, NC 27514