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HelpEpic Test Code LAB345 SS-B/La Antibodies, IgG, Serum
Additional Codes
MML Code: SSB
LIS Code: SJO2
NY State Approved
YesPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Reporting Name
SS-B/La Ab, IgG, SMethod Name
Multiplex Flow Immunoassay
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 21 days | |
| Frozen | 21 days |
Specimen 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 Type
SerumSpecimen Minimum Volume
0.35 mL
Reference Values
<1.0 U (negative)
≥1.0 U (positive)
Reference values apply to all ages.
Report Available
1 to 3 daysDay(s) Performed
Monday through Saturday
CPT Code Information
86235
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | OK |
| Heat-treated | Reject |
Useful For
Evaluating patients with clinical features or at-risk for connective tissue disease, especially Sjögren syndrome.
Testing Algorithm
For more information see Connective Tissue Disease Cascade.
Special Instructions
Clinical Information
Sjogren syndrome (SjS) is a heterogeneous systemic autoimmune rheumatic disorder characterized by diverse immunologic responses to SS-A/Ro and SS-B/La antigens.(1) These immune reactivities have been implicated in the destruction of the epithelium of the exocrine glands with the demonstration of typical peri-epithelial lymphocytic infiltration that can vary from sicca syndrome to systemic disease and lymphoma.(2) The SS-A/Ro and SS-B/La system is considered as a heterogeneous antigenic complex which is made up of three different proteins (Ro52, Ro60 and La) and four small RNAs particles.(1,2) The SS-B/La antigen is a 48 kDa phosphorylated protein which can be found in the nucleus and the cytoplasm and binds to several RNA molecules.(3) SS-B/La appears to be susceptible to proteolysis and degrades into smaller but immunoreactive polypeptides.(4)
Unlike antibodies to SS-A/Ro that are present in SjS and other connective tissue diseases (CTD) [systemic lupus erythematosus, systemic sclerosis, inflammatory myopathies, overlap CTD] and primary biliary cholangitis, anti-SS-B/La antibodies are found primarily in patients with SjS.(2,5,6) In addition, SS-A/Ro antibodies may be found alone in many patients with SjS, however, anti-SS-B/La autoantibodies without SS-A/Ro has limited significant association for SjS diagnosis or phenotypic categorization.(2,6,7) Lastly, whereas testing for anti-SS-A/Ro antibodies is included in the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary SjS, evaluation of anti-SS-B/La antibodies is not required.(8)
In a recent multicenter study of more than 10,500 patients with primary SjS, anti-SSB/La antibodies were detected in 58% of anti-SSA/Ro antibody-positive cases.(9) Anti-SS-B/La antibodies are detected using a variety of solid-phase (eg, plate, bead, or membrane) immunoassays such as enzyme-linked immunosorbent assay, fluorometric enzyme-linked immunoassays, chemiluminescence immunoassays, addressable laser bead immunoassay particle-based multianalyte technology and dot or line immunoassays.(10)
For more information see Connective Tissue Disease Cascade.
Interpretation
A positive result for anti-SS-B/La antibodies may be suggestive of a diagnosis of primary or secondary connective tissue disease including Sjogren syndrome if compatible autoantibody profile and clinical symptoms are present. The positive predictive value for primary Sjogren syndrome is increased with positivity for antibodies to Ro52, Ro60, and SS-B/La. Combination of anti-SSB-B/A and anti-Ro52 and/or anti-Ro60 antibodies may also be useful in the phenotypic stratification of patients with primary Sjogren syndrome.
Cautions
Low levels and/or single positivity for anti-SS-B/La antibodies are likely to have limited clinical significance for the diagnosis and phenotypic stratification of patients with primary Sjogren syndrome.