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Worcestershire Acute Hospitals NHS Trust
ANCA (Antineutrophil Cytoplasmic Antibody)
Referral code
Test information
This assay is useful in the diagnosis and management of patients with suspected pulmonary-renal syndrome or ANCA-associated small vessel vasculitis. There are 2 common staining patterns seen on immunofluorescence: cytoplasmic- ANCA (C-ANCA) and perinuclear-ANCA (p-ANCA). Other atypical patterns are sometimes seen, but may not have any clinical significance. 
C-ANCA pattern (IIF) directed against Proteinase 3 (PR3 � detected by ELISA) is strongly associated with Wegener�s granulomatosis. . C-ANCA antibody levels may relate to disease activity and will fall to normal with effective treatment. 
P-ANCA pattern directed against myeloperoxidase (MPO- ELISA) is commonly associated with microscopic polyangiitis (MPA) and other ANCA-associated small vessel vasculitides, but may also be seen in non-vasculitic chronic inflammatory conditions, such as, ulcerative colitis, rheumatoid arthritis and chronic hepatitis.   
C-ANCA or p-ANCA pattern on IIF not directed against PR3/MPO are less likely to be clinically significant and may not reflect ANCA-related small vessel vasculitides. 
Special requirements
Plasma or Serum
Tube type
SST, Plain or Lithium Heparin
Gold, red and green top tubes
Assay frequency
TAT GP/Outpatient
up to 7 days. Urgent assay is available.
Referral lab
Immunology Russells Hall Hospital
Page last updated: 11 January 2022