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HelpTest Code SSAB SS-A and SS-B Antibodies, IgG, Serum
Additional Codes
Sjogren
Reporting Name
SSA/SSBUseful For
Evaluating patients with signs and symptoms of a connective tissue disease in whom the test for antinuclear antibodies is positive, especially those with signs and symptoms consistent with Sjogren syndrome or lupus erythematosus
This test is not useful in patients without demonstrable antinuclear antibodies.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| SSA | SS-A/Ro Ab, IgG, S | Yes | Yes |
| SSB | SS-B/La Ab, IgG, S | Yes | Yes |
Testing Algorithm
For more information see Connective Tissue Disease Cascade.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumSpecimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
0.35 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 21 days | |
| Frozen | 21 days |
Special Instructions
Reference Values
SS-A/Ro ANTIBODIES, IgG
<1.0 U (negative)
≥1.0 U (positive)
Reference values apply to all ages.
SS-B/La ANTIBODIES, IgG
<1.0 U (negative)
≥1.0 (positive)
Reference values apply to all ages.
Day(s) Performed
Monday through Saturday
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
86235 x 2
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| SSAB | SSA/SSB | 87555-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| SSA | SS-A/Ro Ab, IgG, S | 33610-7 |
| SSB | SS-B/La Ab, IgG, S | 33613-1 |
Interpretation
A positive result for SSA (Ro) or SSB (La) antibodies is highly suggestive of a diagnosis of Sjogren syndrome.
The presence of isolated anti-SS-B/La antibody has low positive predictive value of Sjogren syndrome.
A positive result for SS-A/Ro antibodies may be suggestive of connective tissue disease (CTD) such as Sjogren syndrome, systemic lupus erythematosus (SLE), systemic sclerosis, inflammatory myopathies (especially in patients with anti-synthetase syndrome), CTD-associated with interstitial lung diseases, or rheumatoid arthritis.
A positive result for SS-A/Ro antibodies in a woman with SLE prior to delivery indicates an increased risk of congenital heart block in the neonate.
Differential testing for Ro52 and Ro60 antibodies in patients positive for SS-A/Ro may be useful in the diagnosis of specific CTD clinical subset, disease stratification, and prognosis. Consider testing for Ro52 and Ro60 antibodies (ROPAN / Ro52 and Ro60 Antibodies, IgG, Serum) if the patient is positive for SS-A/Ro.
Clinical Reference
1. Brito-Zeron P, Baldini C, Bootsma H, et al. Sjogren syndrome. Nat Rev Dis Primers. 2016;2:16047
2. VÃlchez-Oya F, Balastegui Martin H, Garcia-Martinez E, Corominas H. Not all autoantibodies are clinically relevant. Classic and novel autoantibodies in Sjogren's syndrome: A critical review. Front Immunol. 2022;13:1003054
3. Bachman M, Mayet WJ, Shroder HC, et al. Association of La and Ro antigens with intracellular structures in HEp-2 carcinoma Cells. Proc Natl Acad Sci USA. 1986;83(20):7770-7774
4. Habets WJ, den Brok JH, Boerbooms AM, van de Putte LB, van Venrooij WJ. Characterization of SS-B (La) antigen in adenovirus-infected and uninfected HeLa cells. EMBO J. 1983;2(10):1625-1631
5. Deroo L, Achten H, De Boeck K, et al. The value of separate detection of anti-Ro52, anti-Ro60 and anti-SSB/La reactivities in relation to diagnosis and phenotypes in primary Sjogren's syndrome. Clin Exp Rheumatol. 2022;40(12):2310-1317
6. Baer AN, McAdams DeMarco M, Shiboski SC, et al. The SSB-positive/SSA-negative antibody profile is not associated with key phenotypic features of Sjögren's syndrome. Ann Rheum Dis. 2015;74(8):1557-1561
7. Acar-Denizli N, Horvath IF, Mandl T, et al. Systemic phenotype related to primary Sjogren's syndrome in 279 patients carrying isolated anti-La/SSB antibodies. Clin Exp Rheumatol. 2020;38 Suppl 126(4):85-94
8. Shiboski CH, Shiboski SC, Seror R, et al. 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjogren's syndrome: A consensus and data-driven methodology involving three international patient cohorts. Ann Rheum Dis. 2017;76(1):9-16
9. Brito- Zeron P, Acar-Denizlin N, Ng WF, et al. How immunological profile drives clinical phenotype of primary Sjogren’s syndrome at diagnosis: analysis of 10,500 patients (Sjogren Big Data Project). Clin Exp Rheumatol. 2018; 36 (Suppl. 112): S102-12
10. Schulte-Pelkum J, Fritzler M, Mahler M. Latest update on the Ro/SS-A autoantibody system. Autoimmun Rev. 2009;8(7):632-637
11. Lee AYS, Reed JH, Gordon TP. Anti-Ro60 and anti-Ro52/TRIM21: Two distinct autoantibodies in systemic autoimmune diseases. J Autoimmun. 2021;124:102724
12. Menendez A, Gomez J, Escanlar E, Caminal-Montero L, Mozo L. Clinical associations of anti-SSA/Ro60 and anti-Ro52/TRIM21 antibodies: Diagnostic utility of their separate detection. Autoimmunity. 2013;46(1):32-39
13. Armagan B, Robinson SA, Bazoberry A, et al. Antibodies to both Ro52 and Ro60 for identifying Sjogren's syndrome patients best suited for clinical trials of disease-modifying therapies. Arthritis Care Res (Hoboken). 2022;74(9):1559-1565
14. Buyon JP, Ben-Chetrit E, Karp S, et al. Acquired congenital heart block. Pattern of maternal antibody response to biochemically defined antigens of the SSA/Ro-SSB/La system in neonatal lupus. J Clin Invest. 1989;84(2):627-634. doi:10.1172/JCI114208
15. Robbins A, Hentzien M, Toquet S, et al. Diagnostic utility of separate anti-Ro60 and anti-Ro52/TRIM21 antibody detection in autoimmune diseases. Front Immunol. 2019;10:444
16. Bossuyt X, De Langhe E, Borghi MO, Meroni PL. Understanding and interpreting antinuclear antibody tests in systemic rheumatic diseases. Nat Rev Rheumatol. 2020;16(12):715-726
Report Available
Same day/1 to 3 daysMethod Name
Multiplex Flow Immunoassay