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pANCA in serum; anti-myeloperoxidase in serum; anti-leukocyte elastase in serum

Indications: 1) directed against myeloperoxidase a) Churg-Strauss syndrome (60-70%) b) microscopic polyangiitis (75-80%) c) idiopathic crescentic glomerulonephritis (80%) d) polyarteritis nodosa [3,4]; not helpful e) Wegener's granulomatosis (20%) 2) directed against leukocyte elastase, lactoferrin a) vasculitis - cocaine-associated vasculitis b) primary sclerosing cholangitis (60-85%) c) ulcerative colitis (60-75%) d) primary biliary cirrhosis (30-40%) e) rheumatoid arthritis 1] with Felty's syndrome (90-100%) 2] with vasculitis (50-75%) 3] uncomplicated (20-40%) f) systemic lupus erythematosus (25%) g) 5% of normal subjects 3) p-ANCA may also be positive in: a) autoimmune chronic hepatitis b) hepatitis C c) sulfasalazine toxicity d) Crohn's disease (10-20%) e) juvenile chronic polyarthritis (10-20%) f) ankylosing spondylitis (10-20%) g) psoriatic arthritis (10-20%) Clinical significance: - autoantibody directed against myeloperoxidase or against leukocyte elastase (proteinase-3), lactoferrin Test interactions: - a positive antinuclear antibody (ANA) may result in a positive pANCA [5] Compartment: - perinuclear

Related

elastase-2; neutrophil elastase; leukocyte elastase; medullasin; bone marrow serine protease ( ELA2, ELANE) lactotransferrin; lactoferrin; talalactoferrin; contains: kaliocin-1; lactoferroxin-A; lactoferroxin-B; lactoferroxin-C (LTF, LF) myeloperoxidase (MPO) neutrophil or polymorphonuclear leukocyte (PMN, poly) pANCA (anti-myeloperoxidase, anti-leukocyte elastase)

Specific

atypical pANCA in serum myeloperoxidase antibody in serum pANCA IgG in serum

General

neutrophil cytoplasmic antibody (ANCA) in serum

References

  1. Clinical Guide to Laboratory Tests, NW Tietz (ed) 3rd ed, WB Saunders, Philadelphia 1995
  2. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 782, 847
  3. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 1913
  4. Kaiser Permanente Northern Calfornia Regional Laboratory
  5. Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 19. American College of Physicians, Philadelphia 1998, 2012, 2015, 2022
  6. Bosch X et al, Antineutrophil cytoplasmic antibodies. Lancet 2006, 368:404 PMID: 16876669
  7. Panel of 3 tests Laboratory Test Directory ARUP: 50567