Test Overview
Test Methodology

Indirect Fluorescent Antibody (IFA), human neutrophil substrate

Test Usage

Wegener's granulomatosis is a disease which results in a necrotizing granulomatous vasculitis in the upper and lower respiratory tract as well as in the kidney. The disease has been successfully treated with immunosuppressive drugs. Recently, autoantibodies against neutrophil cytoplasmic antigens have been found in these patients. The antibody is not directed against neutrophil surface antigens. These antibodies have also been observed in microscopic polyarteritis, in systemic lupus erythematosus and in vasculitis. The antibodies correlate best with individuals having a necrotizing crescentic glomerulonephritis with or without systemic illness.

Reference Range *

Negative. Pathologists interpretation of results provided. Two patterns have been recognized. True positive NCA is a finely granular pattern which stains all of the cytoplasm; C-Neutrophil Cytoplasmic autoantibodies (C-NCA) have been described in patients with Wegener's granulomatosis, 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 Wegener's granulomatosis as the cytoplasmic (C-NCA) pattern.

Test Details
Days Set Up
Monday, Thursday
Analytic Time

8 hours

Soft Order Code
MiChart Code
Anti-Neutrophilic Cytoplasmic Antibody
  • NCA
  • Wegener's Granulomatosis (Vasculitis)
  • 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.
Yellow 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. 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
86255-26 Screen, 86256-26 Titer
Reflex CPT
Reflex Fee Code
NY State Approved