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Test ID SSA SS-A/Ro Antibodies, IgG, Serum

Reporting Name

SS-A/Ro Ab, IgG, S

Useful For

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

 

Detection of both anti-SS-A 52 (Ro52) and SS-A 60 (Ro60) antibodies in serum

Testing Algorithm

For more information see Connective Tissue Disease Cascade (CTDC)

Specimen Type

Serum


Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Information: Centrifuge and aliquot serum into 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

Reference Values

<1.0 U (negative)

≥1.0 U (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

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SSA SS-A/Ro Ab, IgG, S 33610-7

 

Result ID Test Result Name Result LOINC Value
SSA SS-A/Ro Ab, IgG, S 33610-7

Clinical Information

SS-A/Ro is an extractable nuclear antigen (ENA) composed of protein antigens of 52 kDa (Ro52) and 60 kDa (Ro60) combined with cytoplasmic RNA species.(1,2) SS-A/Ro (Ro52 and/or Ro60) antibodies occur in patients with several different connective tissue diseases including Sjogren syndrome (SjS), an autoimmune disease that involves primarily the salivary and lachrymal glands (up to 90% of cases); systemic lupus erythematosus (SLE) (40%-60% of cases); and rheumatoid arthritis. SS-A/Ro antibodies are associated with childhood SLE, neonatal SLE, and with congenital heart block in infants born to mothers with LE.(1-4) SjS patients with antibodies to both Ro52 and Ro60 are characterized by higher prevalence of markers of B-cell hyperactivity and glandular inflammation compared to those with single positivity.(2) Although these antibodies are often found together, both autoantibodies have important and distinct diagnostic and predictive attributes and should be distinguished when SS-A/Ro antibody is positive or tested singly.(1)

 

SS-A/Ro is 1 of 4 autoantigens commonly referred to as ENAs. The other ENAs are SS-B/La, RNP (ribonucleoprotein), and Sm (Smith). Each ENA is composed of one or more proteins associated with small nuclear or cytoplasmic RNA species (snRNP) ranging in size from 80 to 350 nucleotides. Antibodies to ENA are common in patients with connective tissue diseases (systemic rheumatic diseases) including SLE, mixed connective tissue disease, SjS, scleroderma (systemic sclerosis), and polymyositis/dermatomyositis.

 

For more information see Connective Tissue Disease Cascade (CTDC).

Interpretation

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 (SSc), inflammatory myopathies especially in patients with anti-synthetase syndrome, CTD-associated with interstitial lung diseases (CTD-ILD), or rheumatoid arthritis.

 

A positive result for SS-A/Ro antibodies in a woman with SLE prior to delivery may suggest an increased risk of congenital heart block in the neonate.

 

Differential testing for Ro52 and Ro60 antibodies in SS-A/Ro positive patients 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. Lee AYS, Reed JH, Gordon TP: Anti-Ro60 and anti-Ro52/TRIM21: Two distinct autoantibodies in systemic autoimmune diseases. J Autoimmun. 2021 Nov;124:102724. doi: 10.1016/j.jaut.2021.102724

2. 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). 2021 Mar 20;10.1002/acr.24597. Epub ahead of print.

3. Homburger H, Larsen S: Detection of specific antibodies. In: Rich R, Fleisher T, Schwartz B, et al, eds. Clinical Immunology: Principles and Practice. 1st ed. Mosby-Year Book; 1996:2096-2109

4. Kotzin B, West S: Systemic lupus erythematosus. In: Rich R, Fleisher T, Shearer W, et al, eds. Clinical Immunology Principles and Practice. 2nd ed. Mosby-Year Book; 2001:60.1-60.24

Report Available

1 to 3 days

Method Name

Multiplex Flow Immunoassay