Table 1

Autoantibodies, their associations in paediatric rheumatic disease, cost and turnaround time

AutoantibodyPaediatric rheumatic disease associationsCost for testTurnaround time
Antinuclear antibodies (ANA)Juvenile systemic lupus erythematosus (JSLE), juvenile idiopathic arthritis (JIA), juvenile dermatomyositis (JDM), mixed connective tissue disease (MCTD), localised scleroderma, systemic sclerosis£9.60 and if ANA screen positive follow-up ANA titration is £11.8010 days for screening, 14 days for titration5
Double-stranded DNAJSLE (also a marker of JSLE disease activity)£6.7121 days for initial FEIA result; further 1 week for confirmatory IIF result5
Anti-neutrophil cytoplasmic antibodies (ANCA): cytoplasmic ANCA (c-ANCA) and perinuclear ANCA (p-ANCA)Granulomatosis with polyangiitis, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitisCost for ANCA is £9.60, for MPO/PR3 the cost is £13.427 days for MPO/PR3, 14 days for ANCA5
Rheumatoid factorHigher risk of aggressive disease in polyarticular JIA£13 days5
Anti-cyclic citrullinated peptideHigher risk of aggressive disease in polyarticular JIA£6.7114 days5
Myositis-specific antibodiesJDMRoutine myositis blot test (sent to Manchester) costs £29.99, myositis specific antibodies (sent to Bath) costs £24021 days14
Anti-RNPMCTD, JSLEENA screen costs £8.21 and if screen is positive follow-up ENA identities (full panel) costs £39.2121 days (screening), further 7 days for identification of positives5
Anti-SmithJSLE
Anti-Ro/Anti-LaJSLE, neonatal lupus, congenital heart block, Sjögren’s
Scl-70Systemic sclerosis
Ribosomal PNeuro JSLE
Anti-centromereSystemic sclerosis, CREST (Calcinosis, Raynaud’s phenomenon, oEsophageal immobility, Sclerodactyly and Telangectasia)
  • These are prices and turnaround times for tests performed by the Queen Elizabeth University Hospital in Glasgow Immunology and Biochemistry Laboratories. Prices and turnaround times will vary across the UK depending on which methodology and staffing expertise are available in each laboratory. In considering the costs of these tests, it is also important to be mindful that there are the additional costs of staffing, materials and referral to rheumatology clinic.

  • FEIA, fluorescence enzyme immunoassay; IIF, indirect immunofluorescence; JIA, juvenile idiopathic arthritis; MPO, myeloperoxidase; PR3, proteinase 3.