Antineutrophil Cytoplasmic Antibodies (ANCA, MPO, PR3)
- Also Known As:
- ANCA Antibodies
- cANCA
- pANCA
- Serine Protease 3
- MPO
- PR3
- Anticytoplasmic Autoantibodies
- 3-ANCA
- PR3-ANCA
- MPO-ANCA
- Myeloperoxidase Antibodies
- Proteinase 3 Antibodies

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At a Glance
Why Get Tested?
To help detect, diagnose, and sometimes monitor certain forms of systemic vasculitis (an autoimmune disorder that causes inflammation of blood vessels)
To help distinguish between Crohn disease (CD) and ulcerative colitis (UC), the two most common types of inflammatory bowel disease (IBD); as an adjunct to other IBD testing
When To Get Tested?
When you have symptoms such as fever, muscle aches, and weight loss or impaired kidney or lung function that your healthcare practitioner thinks may be due to a vascular autoimmune disorder
When you have symptoms such as persistent or intermittent diarrhea and abdominal pain that your health practitioner suspects may be due to an IBD; when your health practitioner wants to distinguish between CD and UC
Sample Required?
A blood sample drawn from a vein in your arm
Test Preparation Needed?
None
You may be able to find your test results on your laboratory’s website or patient portal. However, you are currently at Testing.com. You may have been directed here by your lab’s website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab’s website or portal, or contact your healthcare practitioner in order to obtain your test results.
Testing.com is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.
The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.
If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.
Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called “normal” values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.
While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are “within normal limits.”
For more information, please read the article Reference Ranges and What They Mean.
What is being tested?
Antineutrophil cytoplasmic antibodies (ANCA) are autoantibodies produced by the immune system that mistakenly target and attack specific proteins within neutrophils (a type of white blood cell). ANCA testing detects and measures the amount of these autoantibodies in the blood. Two of the most common ANCAs are the autoantibodies that target the proteins myeloperoxidase (MPO) and proteinase 3 (PR3). These are called pANCAs and cANCAs, respectively.
There are two types of ANCA tests:
The first type is called Indirect Immunofluorescence (IIF). This uses neutrophils fixed onto a slide. For the test, serum from your blood sample is mixed with the neutrophils on the slide and any ANCAs in the sample attach to the neutrophil proteins. Treatment of the slide with a fluorochrome-stained antibody reacts with any ANCA present. This produces a pattern of fluorescence that can be seen under a microscope. The pattern may be identified as cytoplasmic (cANCA), perinuclear (pANCA), or atypical ANCA (X-ANCA).
Alternatively, the laboratory may test for antibodies to myeloperoxidase or to proteinase 3 directly using an ELISA assay.
A combination of both fluorescence and ELISA tests are often done when testing suspected cases of vasculitis.
ANCA may be present in several autoimmune disorders that cause inflammation, tissue damage, and organ failure:
- Systemic vasculitis is a group of disorders associated with damage and weakening of blood vessels. It can cause tissue and organ damage due to the narrowing and obstruction of blood vessels and the subsequent loss of blood supply. It can also produce areas of weakness in blood vessel walls, known as aneurysms, which have the potential to rupture. The symptoms experienced by a person with systemic vasculitis depend upon the degree of autoimmune activity and the parts of the body involved. A few types of systemic vasculitis are closely associated with the production of ANCA:
- Granulomatosis with polyangiitis (Wegener granulomatosis)
- Microscopic polyangiitis
- Eosinophilic granulomatosis with polyangiitis (Churg Strauss syndrome)
- Polyarteritis nodosa (PAN)
cANCA/PR3 antibodies are most frequently seen in granulomatosis with polyangiitis and pANCA/ MPO antibodies are most often associated with microscopic polyangiitis. However, both may be seen in all three types with varying degrees of reactivity.
- Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD) associated with swollen and damaged tissues in the lining of the colon. UC can be difficult to distinguish from Crohn disease (CD), another type of IBD that can affect any part of the intestinal tract. The presence of atypical ANCA is generally associated with UC (80% of patients), while only 20% of CD patients may be positive.
Common Questions
View Sources
Sources Used in Current Review
Hasan, U. (2017 March, Updated). Vasculitis. American College of Rheumatology. Available online at https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Vasculitis. Accessed March 2019.
Tracy, C. and Papdopoulos, P. (2017 December 2, Updated). Granulomatosis with Polyangiitis (Wegener Granulomatosis). Medscape Rheumatology. Available online at https://emedicine.medscape.com/article/332622-overview. Accessed March 2019.
Lowe, S. and Tracy, C. (2017 December 14, Updated). Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome). Medscape Rheumatology. Available online at https://emedicine.medscape.com/article/333492-overview. Accessed March 2019.
Tebo, A. (2018 March, Updated). Systemic Vasculitis. ARUP Consult. Available online at https://arupconsult.com/content/vasculitis. Accessed March 2019.
(© 1995–2018). Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum. Mayo Clinic Mayo Medical Laboratories. Available online at https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/83012. Accessed March 2019.
(© 2018). Granulomatosis with Polyangiitis. The John Hopkins Vasculitis Center. Available online at https://www.hopkinsvasculitis.org/types-vasculitis/granulomatosis-with-polyangiitis/. Accessed March 2019.
(© 2018). Microscopic Polyangiitis. The John Hopkins Vasculitis Center. Available online at https://www.hopkinsvasculitis.org/types-vasculitis/microscopic-polyangiitis/. Accessed March 2019.
Sources Used in Previous Reviews
(2009 March). Vasculitis. National Heart Lung and Blood Institute [On-line information]. Available online at http://www.nhlbi.nih.gov/health/dci/Diseases/vas/vas_whatis.html. Accessed June 2010.
(© 2006-2010). MPO/PR-3 (ANCA) Antibodies : 0050707. ARUP’s Laboratory Test Directory [On-line information]. Available online at http://www.aruplab.com/guides/ug/tests/0050707.jsp. Accessed June 2010.
(Updated 2009 August). Vasculitis – ANCA. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/ANCA.html?client_ID=LTD. Accessed June 2010.
Borigini, M.J. (Updated 2009 May 31). Necrotizing Vasculitis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000432.htm. Accessed June 2010.
Mayo Clinic Staff (2009 October 10). Vasculitis [On-line information]. Available online at http://www.mayoclinic.com/health/vasculitis/DS00513/METHOD=print. Accessed June 2010.
Revelo, P. and Tebo, A. (Updated 2009 August). Goodpasture Syndrome – Anti-GBM Disease. (ARUP Consult) [On-line information]. Available online at http://www.arupconsult.com/Topics/GoodpastureSyndrome.html?client_ID=LTD#. Accessed June 2010.
Gota, C. (Updated 2008 May). Introduction: Vasculitis. Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec04/ch033/ch033a.html. Accessed June 2010.
Trevisin, M. et. al. (2008 March 10). Antigen-Specific ANCA ELISAs Have Different Sensitivities for Active and Treated Vasculitis and for Nonvasculitic Disease. Medscape from American Journal of Clinical Pathology. 2008;129(1):42-53 [On-line information]. Available online at http://www.medscape.com/viewarticle/568996. Accessed June 2010.
(Updated 2009 January 30). Anti-Neutrophile Cytoplasmic Antibody, Serum. Pathology Associates of Lexington, P.A. [On-line information]. Available online at http://www.palpath.com/MedicalTestPages/anca.htm. Accessed June 2010.
(© 1995–2010) Unit Code 83012: Antineutrophil Cytoplasmic Antibodies Vasculitis Panel, Serum. Mayo Clinic, Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/83012. Accessed June 2010.
Papadopoulos, P. and O’Brian, R. (Updated 2009 August 4). Wegener Granulomatosis. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/332622-overview. Accessed June 2010.
Lohr, J. and Owens, K. (Updated 2008 September 4). Glomerulonephritis, Rapidly Progressive. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/240457-overview. Accessed June 2010.
Pagana, K. D. & Pagana, T. J. (© 2007). Mosby’s Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 88-89.
Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO., Pp 750-751, 928-929.
Henry’s Clinical Diagnosis and Management by Laboratory Methods. 21st ed. McPherson R, Pincus M, eds. Philadelphia, PA: Saunders Elsevier: 2007, Pp 935-937.
Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL eds (2005). Harrison’s Principles of Internal Medicine, 16th Edition, McGraw Hill, Pp 2002-2003.
(© 1995–2014). Cytoplasmic Neutrophil Antibodies, Serum. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/9441. Accessed April 2014
Schlaberg, R. and Tebo, A. (Reviewed 2014 March). Inflammatory Bowel Disease – IBD. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/IBD.html. Accessed April 2014
Rowe, W. and Lichtenstein, G. (Updated 2013 November 25). Inflammatory Bowel Disease. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/179037-overview. Accessed April 2014
Ghazi, L. (Updated 2014 January 13). Crohn Disease. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/172940-overview. Accessed March 2014.
Basson, M. (Updated 2013 May 27). Ulcerative Colitis. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/183084-overview. Accessed March 2014.
(Reviewed 2012 December). Inflammatory Bowel Disease Differentiation Panel. Quest Diagnostics [On-line information]. Available online at http://www.questdiagnostics.com/testcenter/testguide.action?dc=TS_IBD_Differention_Panel. Accessed April 2014
Walfish, A. and Sachar, D. (Revised 2012 December). Crohn Disease. Merck Manual for Healthcare Professionals [On-line information]. Available online through http://www.merckmanuals.com. Accessed March 2014.
Furata, S. and Jayne, D. (2014). Emerging Therapies in Antineutrophil Cytoplasm Antibody-Associated Vasculitis. Medscape Multispecialty from Curr Opin Rheumatol. 2014;26(1):1-6. [On-line information]. Available online at http://www.medscape.com/viewarticle/821352. Accessed April 2014
(2011 April 1). What is Vasculitis? National Heart, Lung, and Blood Institute. [On-line information]. Available online at http://www.nhlbi.nih.gov/health/health-topics/topics/vas/. Accessed April 2014
Bronfenbrener, R (October 12, 2012) Antineutrophil Cytoplasmic Autoantibody, Cytoplasmic (c-ANCA). Medscape Reference. Available online at http://emedicine.medscape.com/article/2086572-overview. Accessed May 2014.
Millet A, et. al. Antineutrophil Cytoplasmic Antibody-Associated Vasculitides. Ann Rheum Dis. 2013;72(8):1273-1279. Available online at http://www.medscape.com/viewarticle/809119. Accessed May 2014.
Pagana, K. D. & Pagana, T. J. (© 2011). Mosby’s Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 90-91.
Shah A, Bylund DJ, McCallum RM. (2011) Vasculitis, in Henry’s Clinical Diagnosis by Laboratory Methods, 22nd ed. McPherson RA, Pincus MR, eds. Elsevier-Saunders: Philadelphia.Chap 52, Pp 991-1002.
Watnick S, Dirkx T (2014). Kidney Disease, in Current Medical Diagnosis and Treatment. Papadakis MA, McPhee SJ, Rabow MW., eds. McGraw-Hill:New York. Chap 22.
Nachman PH, Denu-Ciocca CJ. (2009). Chapter 31. Vasculitides. In: Lerma EV, Berns JS, Nissenson AR. eds. CURRENT Diagnosis & Treatment: Nephrology & Hypertension. New York, NY: McGraw-Hill.
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