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Test Code SSB SS-B/La Antibodies, IgG, Serum

Reporting Name

SS-B/La Ab, IgG, S

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.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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 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

<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
SSB SS-B/La Ab, IgG, S 33613-1

 

Result ID Test Result Name Result LOINC Value
SSB SS-B/La Ab, IgG, S 33613-1

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.

Report Available

1 to 3 days

Specimen Retention Time

14 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus OK
Heat-treated Reject

Method Name

Multiplex Flow Immunoassay