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Test ID ROPAN Ro52 and Ro60 Antibodies, IgG, Serum


Specimen Required


Supplies: Sarstedt 5 mL Aliquot Tube (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial

 


Useful For

Detection of anti-SSA 52 (Ro52) or SSA 60 (Ro60) antibodies in serum

 

Evaluating patients at-risk for connective tissue disease with or without interstitial lung disease

 

Differentiation of antibodies to Ro52 and Ro60 in patients known to be positive for anti- SS-A (Ro) antibodies

Profile Information

Test ID Reporting Name Available Separately Always Performed
RO52 Ro52 Antibody, IgG, S Yes Yes
RO60 Ro60 Antibody, IgG, S Yes Yes

Method Name

Chemiluminescent Immunoassay

Reporting Name

Ro52 and Ro60 Antibodies, IgG, S

Specimen Type

Serum

Specimen Minimum Volume

0.8 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  21 days

Clinical Information

Anti- SS-A (Ro) antibodies can occur in patients with a variety of connective tissue diseases including Sjogren syndrome (SS), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and idiopathic inflammatory myopathy (IIM).(1) In addition, children born to mothers positive for anti-SS-A/Ro antibodies are at increased risk for congenital heart block.(2)

 

Anti-SS-A/Ro antibodies can be specific for protein antigens of 52 kDa (Ro52) or 60 kDa (Ro60); these antigens arise from different genes and have unique biological features. The Ro52 antigen is also known as TRIM21; this protein has E3 ligase activity and functions in the process of ubiquitination. The Ro60 antigen is a 60-kDa RNA-binding protein, known to have repair functions for misfolded RNA.(2)

 

Individuals may display antibody reactivity to either Ro52, Ro60, or both. Patients with only anti-Ro52 antibodies display a higher incidence of IIM and SSc. Anti-Ro52 antibodies in conjunction with antisynthetase antibodies such Jo-1 (others include PL-7, PL-12, EJ, and OJ) are highly associated with interstitial lung disease in patients with IIM. In contrast, isolated anti-Ro60 antibodies are associated with increased risk for SLE and, to a lesser degree, for SS. Positivity for both anti-Ro52 and anti-Ro60 antibodies are most strongly associated with SS; this association is even stronger if anti-SS-B/La antibodies are also detected. The presence of anti-Ro52 and anti-Ro60 antibodies may also be observed in patients with SLE.(3,4)

Reference Values

Ro52 ANTIBODY, IgG

<20 CU (negative)

≥20 CU (positive)

Reference values apply to all ages

 

Ro60 ANTIBODY, IgG

<20 CU (negative)

≥20 CU (positive)

Reference values apply to all ages

Interpretation

The presence of antibodies to both SSA 52 (Ro52) or SSA 60 (Ro60) is highly suggestive of a diagnosis of Sjogren syndrome (SS) with positivity for R060 alone more likely to be associated with systemic lupus erythematosus (SLE).

 

Antibodies to Ro52 may be present in patients with idiopathic inflammatory myopathy (IIM), systemic sclerosis (SSc) or overlap connective tissue disease (CTD). In CTD, antibodies to Ro52 alone or in association with other specific autoantibodies may be associated with interstitial lung diseases.

 

Negative results for antibodies to Ro52 and Ro60 does not exclude the possibility of any CTD, including SS, SLE, SSc, and IIM.

Clinical Reference

1. Fayyaz A, Kurien BT, Scofield H: Autoantibodies in Sjogren’s syndrome. Rheum Dis Clin North Am. 2016;42(3):419-434

2. Defendenti C, Atzeni F, Spina MF, et al: Clinical and laboratory aspects of Ro/SSA-52 autoantibodies. Autoimmun Rev. 2010;10(3):150-154

3. 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 Mar 12;10:444

4. Schulte-Pelkum J, Fritzler M, Mahler M: Latest update on the Ro/SS-A autoantibody system. Autoimmun Rev. 2009;8(7):632-637

Day(s) Performed

Monday, Wednesday, Friday

Report Available

1 to 3 days

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
ROPAN Ro52 and Ro60 Antibodies, IgG, S 33610-7

 

Result ID Test Result Name Result LOINC Value
RO52 Ro52 Antibody, IgG, S 53017-0
RO60 Ro60 Antibody, IgG, S 53019-6