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Test ID ANAR Antinuclear Antibodies (ANA), IFA with Reflex to Connective Tissue Disease Antibodies

Useful For

Evaluation of patients with signs and symptoms compatible with connective tissue diseases

 

The testing algorithm is useful in the initial evaluation of patients and performs best in clinical situations in which the prevalence of disease is low.

Profile Information

Test ID Reporting Name Available Separately Always Performed
ANAH2 Antinuclear Ab, HEp-2 Substrate, S Yes Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ANAB Antinuclear Antibody (Multiple), S No No
ADNA DNA Double-Stranded Ab, IgG, S Yes No
RIB Ribosome P Ab, IgG, S Yes No
ENAE Ab to Extractable Nuclear Ag Eval,S Yes No

Testing Algorithm

If antinuclear antibodies (ANA) HEp-2 substrate screen is positive, then ANA multiple will be performed at an additional charge.

If ANAB is <1:160, the cascade will stop and results will be reported.

If ANAB is ≥1:160, then DNA double-stranded antibody, ribosome P antibody, and antibody to extractable nuclear antibody will be performed at an additional charge.

Method Name

Immunofluorescence Assay (IFA)

Reporting Name

ANA Reflex to CTD Ab, S

Specimen Type

Serum

Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 1 mL

Specimen Minimum Volume

.6 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  14 days

Clinical Information

Antinuclear antibodies (ANA) occur in patients with various autoimmune diseases, both systemic and organ specific, but they are particularly common in systemic rheumatic diseases (SRD). The SRDs include systemic lupus erythematosus (SLE), discoid lupus erythematosus, drug-induced lupus erythematosus, mixed connective tissue disease, Sjogren syndrome, scleroderma (systemic sclerosis), CREST syndrome (calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia), rheumatoid arthritis, and polymyositis or dermatomyositis.

 

Autoantibodies with High Specificity for Individual Connective Tissue Diseases

dsDNA antibodies

SLE

Scl 70 antibodies (topoisomerase 1)

Scleroderma

Jo 1 antibodies (histidyl tRNA synthetase)

Polymyositis

SSA/Ro and SSB/La antibodies

Sjogren syndrome

RNP antibodies (in isolation)

MCTD

Sm antibodies

SLE

Ribosome P antibodies

SLE

 

Low titers of ANA reactivity are observed in approximately 5% of apparently healthy individuals and the incidence increases with increasing age. Titers ≥1:160 are generally considered to be clinically significant and more closely related to the presence of active disease. The results of this test must be interpreted in the context of the clinical picture.

Reference Values

<1:40 (Negative)

Cautions

This test is a laboratory diagnostic aid and by itself is not diagnostic. Positive results of this test may occur in apparently healthy people. Therefore, the results of this test must be interpreted by a medical authority in the context of the patient's total clinical condition.

Day(s) Performed

Monday through Friday

Report Available

1 day/2 days if positive

Performing Laboratory

Mayo Medical Laboratories in New England

CPT Code Information

86038-Antinuclear Antibodies (ANA), HEp-2

83516-Ribosome P Antibodies (if appropriate)

86039-Antinuclear Antibody (Multiple) (if appropriate)

86225-DNA Double-Stranded (dsDNA) Antibodies (if appropriate)

86235 x 6-Antibody to Extractable Nuclear Antigen Evaluation (if appropriate)

NY State Approved

Yes