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Test Code CTDCS Connective Tissue Disease Cascade, Serum

Additional Test Codes

Epic Test ID

LAB722

Methodology

Profile Information:

Antinuclear Antibody (ANA)

Cyclic Citrullinated Peptide (CCP) Antibody

 

Performing Laboratory

Bronson Laboratory Services-Chemistry/Immunochemistry

Specimen Requirements

Specimen Type: Serum

Container/Tube: Gold top serum gel-Plain, red-top tube is also acceptable.
Specimen Volume: 2 mL

Specimen Minimum Volume: 0.8 mL

Specimen Transport Temperature

Refrigerate

Reference Values

See individual test listings for reference values.

 

See Connective Tissue Disease Cascade Algorithm in Special Instructions.

 

Connective tissue diseases (CTDs) are a heterogeneous group of systemic autoimmune diseases characterized by abnormal structure or function of 1 or more elements of connective tissue (ie, collagen, elastin, or mucopolysaccharides). Differential diagnosis of CTDs is mainly based on clinical findings, but is complicated by the similarity of their symptoms. Therefore, antibodies to extractable nuclear antigens are useful markers to support the diagnosis or exclusion of CTDs.

 

The most prominent CTDs are systemic lupus erythematosus (SLE)—potentially affecting all organs; Sjogren’s Syndrome (SS)—characterized by diminished lacrimal and salivary gland secretions; scleroderma (systemic sclerosis [SSc])—a chronic, progressive dermatosis; limited systemic sclerosis—a scleroderma also known as CREST syndrome with a more benign disease course; poly-dermatomyositis (PM/DM)—an acute or chronic inflammatory disease of muscle and skin; and mixed connective tissue disease (MCTD)—a syndrome with features of scleroderma, rheumatoid arthritis, SLE, and PM/DM.

 

The presence and specificity of certain autoantibodies gives a strong indication as to the likely CTD involved. The prevalence of marker autoantibodies in particular CTDs are summarized below.

 Autoantibody Associated CTD

Autoantibody

Prevalence

Smith SLE 20-30%
U1-RNP

MCTD

SLE

100%

30-40%

RNP-70

MCTD

SLE

75-95%

10-15%

SS-A/Ro

Sjogren’s Syndrome

SLE

60-90%

40-50%

SS-B/La

Sjogren’s Syndrome

SLE

50-95%

0-15%

Scl-70 Systemic sclerosis 30-60%
Centromere

CREST syndrome

Primary biliary cirrhosis

70-80%

10-20%

Jo-1 Poly-dermatomyositis 25-35%

Day(s) Test Set Up

Monday through Friday

Test Classification and CPT Coding

86038-ANA

86200-CCP