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Test Code ANA Antinuclear Antibodies (ANA)

Important Note

Includes an ANA screen and titer if screen is positive. Patterns are reported.

Performing Laboratory

Memorial Hospital Laboratory- Virology Laboratory 304-388-9618

Specimen Requirements

Serum-Plain Red Top Tube

Draw 4 ml (minimum 2 mL) blood 

Allow sample to clot naturally before centrifugation

Centrifuge and remove serum within 8 hours of collection    

Specimen Rejection

  • Improperly labeled, collected, stored, and transported
  • Quantity not sufficient
  • Hemolyzed serum
  • Serum subject to repeat freeze thaw cycles.

Storage and Stability

Room Temperature                      Up to 8 hours
Refrigerate > 8 hours prior to testing                 
Freeze > 5 days before testing

Reference Values

<40

Methodology

Indirect Immunofluorescence

Days Test Set Up and Turnaround

Monday through Friday, 8:00AM Start Time

Results available same day as testing.

CPT Coding

86038-screen

86039-titer 

Additional Information

PATTERN

ANTIGEN ASSOCIATION

DISEASE ASSOCIATION

Homogeneous or peripheral

DNA, DNP (deoxyribonucleoprotein)

Systemic lupus erythematosus (SLE); titers usually >640 in untreated SLE patients; may be seen in patients with autoimmune diseases, usually in lower titers. 40-160 titers may be seen in individuals without clinical disease.

Nucleolar

Nucleolar (4-5 S RNA)

Progressive systemic sclerosis(Scleroderma); SLE

Speckled

Centromere

CREST syndrome

Speckled

Sm (Smith Antibody)

SLE

Speckled

SS-B

Sjogren's syndrome

Speckled

RNP

Mixed connective tissue disease

Not detected by ANA test

SS-A

Sjogren's syndrome

 

 

According to information presented at the College of American Pathologists Conference XXXII in May 1998, the following conditions are associated with positive indirect immunofluorescence ANA test results: 

Disease   Frequency of Positive ANA Result, %

Diseases for which an ANA test is very useful for diagnosis:

 

Systemic lupus erythematosus (SLE)
Systemic sclerosis (scleroderma) 

 

 

 

95-100%
60-80%

Diseases for which an ANA test is somewhat useful for diagnosis:

 

Sjögren’s syndrome
Idiopathic inflammatory myositis (dermatomyositis or polymyositis) 

 

 

 

40-70%

30-80% 

Diseases for which an ANA test is useful for monitoring or prognosis:

 

Juvenile chronic oligoarticular arthritis with uveitis
Raynaud phenomenon 

 

 

 

20-30%

 

20-60% 

Conditions in which a positive ANA test result is an intrinsic part of the diagnostic criteria:

 

Drug-induced SLE
Autoimmune hepatic disease
Mixed connective tissue disease 

 

 

 

 

100%

100%
100%

Diseases for which an ANA test is not useful in diagnosis:

 

Rheumatoid arthritis
Multiple sclerosis
Idiopathic thrombocytopenia purpura
Thyroid disease
Discoid lupus
Infectious diseases
Malignancies
Patients with silicone breast implants
Fibromyalgia 

 

 

 

30-50%
25%
10-30%
30-50%
5-25%
Varies widely
Varies widely
15-25%
15-25%

ANA may be seen in normal persons. Prevalence of a positive ANA test is directly proportional to the titer and is more frequent in the female gender and persons of increased age.
ANA Titer % Prevalence in Normal Persons
>40 20-30%
>80 10-12%
>160 5%
>320

3%