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MPO-ANCA (Also known as P-ANCA)

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Report in 12Hrs

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nofastingrequire

No Fasting Required

Details

Investigate symptoms like hematuria, proteinuria, chronic sinusitis, or lung nodules

₹599₹1,320

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MPO-ANCA (P-ANCA) Test Information Guide

  • Why is it done?
    • Detects antibodies against myeloperoxidase (MPO), an enzyme present in neutrophil granules; helps diagnose vasculitis and autoimmune diseases
    • Primary indication: Diagnosis of microscopic polyangiitis (MPA) and other ANCA-associated vasculitides
    • Monitors disease activity and treatment response in patients with established vasculitis
    • Investigates cases presenting with unexplained glomerulonephritis, pulmonary hemorrhage, or multi-system inflammation
    • Performed when patients present with systemic symptoms including fever, malaise, arthralgia, or unexplained organ dysfunction
    • Part of ANCA screening panel when vasculitis is clinically suspected
  • Normal Range
    • Normal/Negative Result: Less than 1.0 AU/mL (arbitrary units per milliliter) or negative by ELISA (enzyme-linked immunosorbent assay)
    • Borderline/Equivocal: 1.0-1.5 AU/mL; requires clinical correlation and possible repeat testing
    • Positive Result: Greater than 1.5 AU/mL or clearly positive by ELISA
    • Units of Measurement: Arbitrary Units per milliliter (AU/mL) or percentage of positive control
    • Reference ranges may vary between laboratories; consult specific laboratory reference values
    • Negative result indicates absence of anti-MPO antibodies; positive result suggests presence of ANCA-associated vasculitis or related autoimmune condition
  • Interpretation
    • Negative Result: MPO-ANCA antibodies not detected; vasculitis due to ANCA less likely; does not exclude other vasculitis types or autoimmune conditions
    • Low-Positive Result (1.5-5.0 AU/mL): Weak positive; requires clinical correlation; may represent early disease or declining antibody titers during treatment
    • Moderate-Positive Result (5.0-10.0 AU/mL): Consistent with ANCA-associated vasculitis; supports clinical diagnosis in appropriate clinical context
    • High-Positive Result (>10.0 AU/mL): Strong positive; highly suggestive of active ANCA-associated vasculitis; often correlates with disease activity
    • Clinical Significance: P-ANCA pattern with MPO positivity is most common in microscopic polyangiitis (MPA); can occur in other conditions including drug-induced vasculitis and ulcerative colitis
    • Factors Affecting Results: Active infection or malignancy may cause false positives; recent vaccination or immunosuppressive therapy may suppress antibody production; certain medications (hydralazine, propylthiouracil) associated with drug-induced ANCA vasculitis
    • Serial Measurements: Rising titers may indicate disease relapse or inadequate treatment response; declining titers often correlate with successful treatment and disease remission
    • Test Specificity: MPO-ANCA positive in approximately 50-60% of MPA cases; combined with clinical presentation and tissue biopsy improves diagnostic accuracy
  • Associated Organs
    • Primary Organ Systems: Kidneys (glomerulonephritis), lungs (pulmonary hemorrhage/alveolitis), peripheral nervous system (neuropathy), skin (cutaneous vasculitis), and joints
    • Kidney Involvement: ANCA-associated glomerulonephritis; rapidly progressive glomerulonephritis (RPGN); pauci-immune crescentic glomerulonephritis
    • Pulmonary System: Pulmonary hemorrhage; diffuse alveolar hemorrhage; pulmonary infiltrates; interstitial lung disease; bronchiolitis obliterans organizing pneumonia (BOOP)
    • Primary Diseases Associated: Microscopic polyangiitis (MPA) - most common; drug-induced ANCA vasculitis (hydralazine, PTU); ulcerative colitis; inflammatory bowel disease
    • Other Associated Conditions: Granulomatosis with polyangiitis (GPA) - less frequent MPO positivity; eosinophilic granulomatosis with polyangiitis (EGPA); systemic lupus erythematosus (SLE)
    • Potential Complications: Acute kidney injury progressing to end-stage renal disease; respiratory failure from pulmonary hemorrhage; peripheral neuropathy causing nerve damage; cutaneous necrosis from skin vasculitis
    • Systemic Effects: Fever, weight loss, malaise; elevated inflammatory markers (ESR, CRP); constitutional symptoms reflecting multi-system inflammation
    • Treatment Risks: Immunosuppressive therapy required may increase infection susceptibility; cumulative toxicity from long-term corticosteroids and cytotoxic agents
  • Follow-up Tests
    • ANCA Panel Testing: PR3-ANCA (C-ANCA) to differentiate GPA from MPA; both MPO-ANCA and PR3-ANCA assessment for comprehensive diagnosis
    • Immunofluorescence Microscopy: Confirms ANCA pattern (P-ANCA vs C-ANCA); essential for diagnosis if serology equivocal
    • Tissue Biopsy: Kidney biopsy for histological confirmation of pauci-immune crescentic glomerulonephritis; lung biopsy if diagnosis uncertain
    • Comprehensive Metabolic Panel: Assess renal function (creatinine, BUN) and electrolytes; essential for baseline and monitoring
    • Urinalysis and 24-Hour Urine Protein: Detects hematuria and proteinuria; quantifies protein loss; critical for renal involvement assessment
    • Inflammatory Markers: Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP); track disease activity and treatment response
    • Complete Blood Count: Assess for anemia, leukocytosis, or thrombocytopenia; monitor for treatment-related cytopenias
    • Chest X-ray and High-Resolution CT: Evaluate for pulmonary involvement; detect infiltrates, hemorrhage, or nodules
    • Other Autoimmune Serologies: ANA, anti-GBM, anti-TNF-alpha antibodies; differentiate ANCA vasculitis from other autoimmune diseases
    • Monitoring Schedule: Serial MPO-ANCA testing every 3-6 months during active disease; every 6-12 months during remission to detect relapses early
    • Baseline Testing Before Immunosuppression: Comprehensive metabolic panel, CBC, hepatic function tests; establish baseline for monitoring treatment toxicity
  • Fasting Required?
    • No Fasting Required: MPO-ANCA testing does not require fasting; blood sample can be drawn at any time of day
    • Sample Collection: Standard venipuncture; approximately 5-10 mL of blood collected in standard serum separator tube (SST)
    • No Medication Restrictions: No specific medications need to be withheld before testing
    • Important Medications to Report: Hydralazine, propylthiouracil (PTU), sulfasalazine, and other drugs associated with drug-induced ANCA vasculitis should be documented; current immunosuppressive therapy should be noted
    • Patient Preparation: No special preparation needed; standard phlebotomy precautions apply; inform phlebotomist if patient has history of vasculitis or bleeding disorders
    • Sample Stability: Allow blood to clot at room temperature; serum should be separated and refrigerated if delay in testing expected
    • Timing Considerations: Optimal timing for initial testing is during acute clinical presentation; subsequent testing typically performed every 3-6 months for monitoring
    • Processing Time: Results typically available within 2-5 business days depending on laboratory; expedited testing available if clinically indicated

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