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Antinuclear-antibody-ana



Why Get Tested

To evaluate for certain autoimmune disorders such as systemic lupus erythematosus SLE and Sjogren syndrome among other types

When To Get Tested

When your healthcare provider thinks that you have symptoms of an autoimmune disorder

Sample Required

A blood sample drawn from a vein in your arm

Test Preparation Needed

None




Common Questions


The antinuclear antibody ANA test is used as a primary test to help evaluate a person for autoimmune disorders that affect many tissues and organs throughout the body systemic and is most often used as one of the tests to help diagnose systemic lupus erythematosus SLE ANA are a group of autoantibodies produced by a person s immune system when it fails to adequately distinguish between self and nonself They target substances found in the nucleus of a cell and cause organ and tissue damage Depending on a person s signs and symptoms and the suspected disorder ANA testing may be used along with or followed by other autoantibody tests Some of these tests are considered subsets of the general ANA test and detect the presence of autoantibodies that target specific substances within cell nuclei including anti-dsDNA anti-centromere anti-nucleolar anti-histone and anti-RNA antibodies An ENA panel may also be used in follow up to an ANA These supplemental tests are used in conjunction with a person s clinical history to help diagnose or rule out other autoimmune disorders such as Sj gren syndrome polymyositis and scleroderma Different laboratories may use different test methods to detect ANA Two common methods include immunoassay and indirect fluorescent antibody IFA IFA is considered the gold standard Some laboratories will use immunoassay to screen for ANA and use IFA to confirm positive or equivocal results Indirect fluorescent antibody IFA this is a method in which a person s blood sample is mixed with cells that are affixed to a slide Autoantibodies that may be present in the blood react with the cells The slide is treated with a fluorescent antibody reagent and examined under a microscope The presence or absence and pattern of fluorescence is noted Immunoassays--these methods are usually performed on automated instrumentation but may be less sensitive than IFA in detecting ANA Other laboratory tests associated with the presence of inflammation such as erythrocyte sedimentation rate ESR and or C-reactive protein CRP may also be used to evaluate a person for SLE or other autoimmune disese

The ANA test is ordered when someone shows signs and symptoms that are associated with a systemic autoimmune disorder People with autoimmune disorders can have a variety of symptoms that are vague and non-specific and that change over time progressively worsen or alternate between periods of flare ups and remissions Some examples of signs and symptoms include Low-grade fever Persistent fatigue weakness Arthritis-like pain in one or more joints Red rash for lupus one resembling a butterfly across the nose and cheeks Skin sensitivity to light Hair loss Muscle pain Numbness or tingling in the hands or feet Inflammation and damage to organs and tissues including the kidneys lungs heart lining of the heart central nervous system and blood vessels

A positive ANA test result means that autoantibodies are present In a person with signs and symptoms this suggests the presence of an autoimmune disease but further evaluation is required to assist in making a final diagnosis Tests for ANA Amount of autoantibody present Two types of tests are commonly performed to detect and measure ANA Immunoassay enzyme linked immunosorbent assay ELISA or enzyme immunoassay EIA the results are usually reported as a number with an arbitrary unit of measure abbreviated as a U on the report for example Indirect fluorescent antibody IFA the results of this method are reported as a titer Titers are expressed as ratios For example the result 1 320 means that one part blood sample was mixed with 320 parts of a diluting substance and ANA was still detectable Patterns of cellular fluorescence In addition to a titer positive results on IFA will include a description of the particular type of fluorescent pattern seen Different patterns have been associated with different autoimmune disorders although some overlap may occur Some of the more common patterns include Homogenous diffuse associated with SLE mixed connective tissue disease and drug-induced lupus Speckled associated with SLE Sj gren syndrome scleroderma polymyositis rheumatoid arthritis and mixed connective tissue disease Nucleolar associated with scleroderma and polymyositis Centromere pattern peripheral associated with scleroderma and CREST Calcinosis Raynaud syndrome Esophogeal dysmotility Sclerodactyly Telangiectasia A positive result from the ELISA or EIA method will be a number of units that is above the laboratory s reference number cutoff for the lowest possible value that is considered positive An example of a positive result using the IFA method would give the dilution titer and a description of the pattern such as Positive at 1 320 dilution with a homogenous pattern For either method the higher the value reported the more likely the result is a true positive ANA test results can be positive in people without any known autoimmune disease and thus need to be evaluated carefully in conjunction with an individual s signs and symptoms An ANA test may become positive before signs and symptoms of an autoimmune disease develop so it may take time to tell the meaning of a positive ANA in a person who does not have symptoms Conditions associated with a positive ANA test The most common condition is SLE SLE ANA are most commonly seen with SLE About 95 of those with SLE have a positive ANA test result If someone also has symptoms of SLE such as arthritis a rash and skin sensitivity to light then the person probably has SLE A positive anti-dsDNA and anti-SM often ordered as part of an ENA panel help confirm that the condition is SLE Other conditions in which a positive ANA test result may be seen include Drug-induced lupus a number of medications may trigger this condition which is associated with SLE symptoms When the drugs are stopped the symptoms usually go away Although many medications have been reported to cause drug-induced lupus those most closely associated with this syndrome include hydralazine isoniazid procainamide and several anticonvulsants Because this condition is associated with the development of autoantibodies to histones an anti-histone antibody test may be ordered to support the diagnosis Sj gren syndrome 40-70 of those with this condition have a positive ANA test result While this finding supports the diagnosis a negative result does not rule it out A health practitioner may want to test for two subsets of ANA Anti-SS-A Ro and Anti-SS-B La About 90 or more of people with Sj gren syndrome have autoantibodies to SSA Scleroderma systemic sclerosis About 60-90 of those with scleroderma have a positive ANA In people who may have this condition ANA subset tests can help distinguish two forms of the disease limited versus diffuse The diffuse form is more severe The limited form is most closely associated with the anticentromere pattern of ANA staining and the anticentromere test while the diffuse form is associated with autoantibodies to Scl-70 Less commonly ANA may occur in people with Raynaud syndrome arthritis dermatomyositis or polymyositis mixed connective tissue disease and other autoimmune conditions For more on these read the article on Autoimmune Diseases A health practitioner must rely on test results clinical symptoms and the person s history for diagnosis Because symptoms may come and go it may take months or years to show a pattern that might suggest SLE or any of the other autoimmune diseases A negative ANA result makes SLE an unlikely diagnosis It usually is not necessary to immediately repeat a negative ANA test however due to the episodic nature of autoimmune diseases it may be worthwhile to repeat the ANA test at a future date if symptoms recur Aside from rare cases further autoantibody subset testing is not necessary if a person has a negative ANA result

ANA testing is not used to track or monitor the clinical course of SLE thus serial ANA tests for diagnosed patients are not commonly ordered Use of a number of drugs some infections autoimmune hepatitis and primary biliary cirrhosis as well as other conditions mentioned above can give a positive result for the ANA test About 3-5 of healthy Caucasians may be positive for ANA and it may reach as high as 10-37 in healthy individuals over the age of 65 because ANA frequency increases with age These would be considered false-positive results because they are not associated with an autoimmune disease Such instances are more common in women than men

ANA are autoantibodies that are directed against certain components found in the nucleus of a cell hence the name antinuclear

A positive ANA result means that you have a higher than normal concentration of these antibodies This is one of the tools in diagnosing lupus as well as several other autoimmune diseases so a positive result may be related to lupus or to another disease Or you may simply have a higher than normal concentration of these autoantibodies that may not have any impact on your health Even among people with lupus ANA results can vary widely one person can be in remission at a certain titer of ANA while another can be extremely ill at the same titer Autoimmune diseases often have a systemic effect on the body and are very complex by nature Your healthcare provider will interpret what the test results mean for you and may need to compare your test results as well as the severity of your symptoms over a period of time in order to make a definitive diagnosis This additional time may also allow your healthcare provider to eliminate other possible causes of your symptoms Another diagnostic tool is to perform additional testing for the autoantibodies Smith and ds-DNA which if possitive would confirm SLE

There are actually several forms of lupus SLE is the form that is most commonly referred to when someone mentions lupus Systemic lupus means that almost any organ or system in your body can be affected This is the most severe form There are other forms of lupus that are primarily limited to skin such as discoid and subacute cutaneous lupus Symptoms include rashes that may be found in many shapes and locations on the body A butterfly-shaped rash is commonly seen on or near the face For more on the different types of lupus refer to the Lupus article