Synonym

• ANCA
• Cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA)
• Neutrophil cytoplasmic antibodies
• Perinuclear antineutrophil cytoplasmic antibody (p-ANCA)

Tubes

• Red or marbled top tube
• 5 mL venous blood

Reject if there is:

• Bacterial contamination
• Gross hemolysis
• Lipemia

Info

• Antineutrophil cytoplasmic antibodies (ANCAs) are autoantibodies directed against antigens seen in the cytoplasmic granules of neutrophils and monocytes
• These antibodies are serological markers that are associated with vasculitis and glomerulonephritis

Clinical

The ANCA test can be helpful in the diagnosis and management of:

• Churg Strauss syndrome (CSS)
• Glomerulonephritis (GN)
• Idiopathic necrotizing GN
• GN with periarteritis
• Microscopic polyangiitis (MPA)
• Renal diseases (other)
• Wegener's granulomatosis
• Vasculitis

Nl Result

Consult your laboratory for their normal ranges as these may vary somewhat from the ones listed below.

• Normal is: None detected or if titer is reports <1:16

High Result

When an ANCA test is positive, one of the following patterns is typical:

1. c-ANCA pattern
• Seen as a granular cytoplasmic pattern on ethanol-fixed neutrophils
• Probably due to antibodies against serine proteinase 3 (anti-PR3)
• Often seen in patients with Wegener's granulomatosis
2. p-ANCA pattern
• Shows a perinuclear distribution
• Mainly due to antibodies against myeloperoxidase (anti-MPO)
• Often associated with systemic vasculitis
• Must be differentiated from antinuclear antibodies by the absence of antibodies to tissue sections of solid organs

Diseases associated with a positive ANCA test includes:

• Wegener's granulomatosis (mostly c-ANCA)
• Glomerulonephritis (mostly p-ANCA)
• Alveolar hemorrhage
• Churg Strauss syndrome
• Crohn's disease
• Felty's syndrome
• Periarteritis nodosa (Microscopic)
• Rheumatoid arthritis
• Systemic lupus erythematosus
• Ulcerative colitis
• Vasculitis (Drug induced or non-syndromic)

References

• Jethwa HS et al. False-positive myeloperoxidase binding activity due to DNA/anti-DNA antibody complexes: a source for analytical error in serologic evaluation of anti-neutrophil cytoplasmic autoantibodies. Clin Exp Immunol 2000;121(3):544-50.
• Laboratory Corporation of America®. Antineutrophil Cytoplasmic Antibodies (ANCA). [Homepage on the Internet]© 2003. Last updated on May 4, 2006. Last accessed on August 7, 2006. Available at URL: http://www.labcorp.com/datasets/labcorp/html/chapter/mono/se017600.htm
• Radice A et al. Contribution of immunofluorescence to the identification and characterization of anti-neutrophil cytoplasmic autoantibodies. The role of different fixatives. Clin Exp Rheumatol 2000;18(6):707-12
• Wiik A. Neutrophil-specific autoantibodies in chronic inflammatory bowel diseases. Autoimmun Rev. 2002;191-20:67-72.