Test Code CTDCS Connective Tissue Disease Cascade, Serum
Epic Test ID
Bronson Laboratory Services-Chemistry/Immunochemistry
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.
Primary biliary cirrhosis
Antinuclear Antibody (ANA)
|Cyclic Citrullinated Peptide (CCP) Antibody|
Specimen Transport Temperature
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
Day(s) Test Set Up
Monday through Friday
Test Classification and CPT Coding