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Test Code RAPAN Rheumatoid Arthritis Panel, Serum


Ordering Guidance


This test is the optimal first-line antibody panel for evaluating patients at-risk for rheumatoid arthritis.

The following testing may also be useful:

ENAE / Antibody to Extractable Nuclear Antigen Evaluation, Serum

ADNA1 / Double-Stranded DNA (dsDNA) Antibodies , IgG, Serum

NAIFA / Antinuclear Antibodies, HEp-2 Substrate, IgG, Serum

CTDC / Connective Tissue Diseases Cascade, Serum



Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Useful For

Evaluating patients suspected of having rheumatoid arthritis (RA)

 

Differentiating RA from other inflammatory arthritis or connective tissue diseases

 

Diagnosis and stratification of rheumatoid arthritis

Profile Information

Test ID Reporting Name Available Separately Always Performed
CCP Cyclic Citrullinated Peptide Ab, S Yes Yes
RHUT Rheumatoid Factor, S Yes Yes

Special Instructions

Method Name

CCP: Enzyme-Linked Immunosorbent Assay (ELISA)

RHUT: Turbidimetry

Reporting Name

Rheumatoid Arthritis Panel, S

Specimen Type

Serum

Specimen Minimum Volume

1.2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  14 days

Reference Values

Cyclic Citrullinated Peptide Antibodies, IgG

<20.0 U (negative)

20.0-39.9 U (weak positive)

40.0-59.9 U (positive)

≥60.0 U (strong positive)

Reference values apply to all ages.

 

Rheumatoid Factor

<15 IU/mL

Interpretation

Cyclic Citrullinated Peptide Antibodies:

A positive result for cyclic citrullinated peptide (CCP) antibodies may be suggestive of rheumatoid arthritis (RA) if compatible clinical features of disease are present.

 

Significantly elevated levels of CCP antibodies may be useful to identify RA patients with erosive joint disease.

 

A Mayo Clinic prospective clinical evaluation of the CCP antibody test showed a diagnostic sensitivity for RA of 78% with fewer than 5% false-positive results in healthy controls (see Cautions).

 

Rheumatoid Factor:

Positive results may be suggestive of RA if compatible clinical features of disease are present.

Clinical Reference

1. Cross M, Smith E, Hoy D, et al. The global burden of rheumatoid arthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1316-1322

2. Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569-2581

3. Burgers LE, Raza K, van der Helm-van Mil AH. Window of opportunity in rheumatoid arthritis - definitions and supporting evidence: from old to new perspectives. RMD Open. 2019;5(1):e000870

4. Deane KD, Holers VM. Rheumatoid arthritis pathogenesis, prediction, and prevention: An emerging paradigm shift. Arthritis Rheumatol. 2021;73(2):181-193

5. Schellekens GA, Visser H, de Jong BA, et al. The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum. 2000;43(1):155-163

6. Derksen VFAM, Huizinga TWJ, van der Woude D. The role of autoantibodies in the pathophysiology of rheumatoid arthritis. Semin Immunopathol. 2017;39(4):437-446

7. Zhu JN, Nie LY, Lu XY, Wu HX. Meta-analysis: compared with anti-CCP and rheumatoid factor, could anti-MCV be the next biomarker in the rheumatoid arthritis classification criteria? Clin Chem Lab Med. 2019;57(11):1668-1679

8. Verheul MK, Bohringer S, van Delft MAM, et al. Triple positivity for anti-citrullinated protein autoantibodies, rheumatoid factor, and anti-carbamylated protein antibodies conferring high specificity for rheumatoid arthritis: Implications for very early identification of at-risk individuals. Arthritis Rheumatol. 2018;70(11):1721-1731

9. Hedstrom AK, Ronnelid J, Klareskog L, Alfredsson L. Complex relationships of smoking, HLA-DRB1 genes, and serologic profiles in patients with early rheumatoid arthritis: Update from a Swedish population-based case-control study. Arthritis Rheumatol. 2019;71(9):1504-1511

10. Emery P, Breedveld FC, Dougados M, Kalden JR, Schiff MH, Smolen JS. Early referral recommendation for newly diagnosed rheumatoid arthritis: evidence based development of a clinical guide. Ann Rheum Dis. 2002;61(4):290-297

11. Cush JJ. Rheumatoid arthritis: Early diagnosis and treatment. Rheum Dis Clin North Am. 2022;48(2):537-547

Day(s) Performed

Monday through Saturday

Report Available

2 to 3 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

86200

86431

LOINC Code Information

Test ID Test Order Name Order LOINC Value
RAPAN Rheumatoid Arthritis Panel, S 46437-0

 

Result ID Test Result Name Result LOINC Value
CCP Cyclic Citrullinated Peptide Ab, S 33935-8
RHUT Rheumatoid Factor, S 11572-5