ARUP's Laboratory Test Directory

Rheumatoid Arthritis Panel with Reflex to Rheumatoid Factors, IgA, IgG, and IgM by ELISA : 2003278

Mnemonic: RA PAN R

Ordering Recommendation: If Rheumatoid Arthritis Panel (2003277) is positive, test reflexes to Rheumatoid Factors, IgA, IgG, and IgM, which may aid in prognostication. Rheumatoid Arthritis Panel is preferred for initial workup of suspected rheumatoid arthritis or undifferentiated inflammatory arthritides.
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Quantitative Immunoturbidimetry/Quantitative Enzyme-Linked Immunosorbent Assay
Performed: Sun-Sat
Reported: 1-4 days
Specimen Required: Patient Prep: Fasting specimen preferred.

Collect: Serum separator tube (SST).

Specimen Preparation: Allow serum to clot completely at room temperature before centrifuging. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.8 mL) Serum is the only acceptable specimen type for this test without a disclaimer.

Storage/Transport Temperature: Refrigerated.

Remarks:

Unacceptable Conditions: Plasma, miscellaneous body fluid, or urine. Contaminated, heat-inactivated, hemolyzed, icteric, or severely lipemic specimens.

Stability (collection to initiation of testing): After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 2 weeks (avoid repeated freeze/thaw cycles)
Reference Interval:
 
Test Number Components Reference Interval
0055256Cyclic Citrullinated Peptide (CCP) Antibody, IgG 19 Units or less: Negative
20-39 Units: Weak positive
40-59 Units: Moderate positive
60 Units or Greater: Strong positive
0050465Rheumatoid Factor 0-14 IU/mL
0051298Rheumatoid Factors, IgA, IgG, and IgM by ELISA  
 
Test Number Components Reference Interval
 Rheumatoid Factor, IgG by ELISA Refer to report
 Rheumatoid Factor, IgM by ELISA Refer to report
 Rheumatoid Factor, IgA by ELISA Refer to report
Interpretive Data: Anti-cyclic citrullinated peptide (anti-CCP), IgG antibodies are present in about 69-83 percent of patients with rheumatoid arthritis (RA) and have specificities of 93-95 percent. These autoantibodies may be present in the preclinical phase of disease, are associated with future RA development, and may predict radiographic joint destruction. Patients with weak positive results should be monitored and testing repeated.
Note: If CCP IgG is 20 Units or greater and/or Rheumatoid Factor is 15 IU/mL or greater, then Rheumatoid Factor, IgG/IgM/IgA by EIA will be performed. Additional charges apply.
CPT Code(s): 86200; 86431; if reflexed, add 83516 x2 and 86431
Cross References: RF (Rheumatoid Arthritis Panel with Reflex to Rheumatoid Factors, IgA, IgG, and IgM by ELISA)