Test Overview
Test Methodology

Indirect Fluorescent Antibody (IFA), human neutrophil substrate

Test Usage

Neutrophil cytoplasmic antibody testing is useful in the evaluation of patients with vasculitis. GPA is a disease which results in a necrotizing granulomatous vasculitis in the upper and lower respiratory tract as well as in the kidney. Autoantibodies against neutrophil cytoplasmic antigens have been found in these patients. These antibodies have also been observed in microscopic polyarteritis, and other types of vasculitis.

Reference Range *

Negative. Pathologists interpretation of results provided. Two common patterns have been recognized. One pattern is a finely granular staining of cytoplasmic granules; C-Neutrophil Cytoplasmic autoantibodies (C-NCA). The most common antibody that accounts for this pattern is anti-proteinase 3. C-NCA has been described in patients with Granulomatosis with Polyangiitis (GPA), polyarteritis nodosa and some types of crescentic glomerulonephritis. The second pattern shows a strong perinuclear fluorescence but little or no staining in the cytoplasm. This pattern has been attributed to anti-myeloperoxidase. The perinuclear NCA pattern (P-NCA) is associated with vasculitis, but is not as specific for GPA as the cytoplasmic (C-NCA) pattern.

* Reference ranges may change over time. Please refer to the original patient report when evaluating results.

Test Details
Days Set Up
Monday, Thursday
Analytic Time

8 hours

Soft Order Code
MiChart Code
ANCA (Neutrophil Cytoplasmic Ab) w/ Reflex Anti-MPO and PR3
  • NCA
  • ANCA
  • Antineutrophil Cytoplasmic Ab
  • NCA
  • C-ANCA
  • P-ANCA
  • NCAB
  • Neutrophil Cytoplasmic Ab, TTR
  • Granulomatosis with Polyangiitis
Chemical Pathology
Specimen Requirements
Collection Instructions

Collect specimen in SST tube. Centrifuge, aliquot serum into a plastic vial and freeze.

Alternate Specimen
Red top tube.
Normal Volume
0.5 mL serum
Minimum Volume
0.5 mL serum
Additional Information

If the screen is positive, a titer will be performed at an additional charge. The pathologist may also request anti-myeloperoxidase and/or anti-proteinase 3 to help in his or her interpretation. By ordering this test the clinician acknowledges that additional reflex testing will be performed and billed at a separate additional charge if indicated. Test includes pathologist interpretation of results billed as a separate additional charge. This test is not available without interpretation.

CPT Code
Fee Code
Pro Fee CPT
Reflex CPT
86037, 86037-26 NCABT, 83516 MYELO, 83516 PR3
Reflex Fee Code
KA042 NCABT, 21594 MYELO, 21595 PR3
17353-4 NCAB, 14277-8 NCABT, 46267-1 PR3N, 63310-7 PR3I, 46266-3 MYLON, 29643-4 MYLOI