Aids in initial diagnosis of connective tissue disease.
Collect
Serum Separator Tube (SST).
Specimen Preparation
Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL)
Unacceptable Conditions
Non-serum, heat inactivated, grossly hemolyzed, or severely lipemic specimens.
Storage/Transport Temperature
Alternate specimen types run with a disclaimer:
1 mL CSF, pleural, pericardial, peritoneal, synovial or supraclavicular fluids.
Stability (from collection to initiation)
After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
Notes
ANA lacks diagnostic specificity, and is associated with a variety of diseases (cancers, autoimmune, infectious, and inflammatory conditions) and occurs in healthy individuals in varying prevalence. The lack of diagnostic specificity requires a confirmation of positive ANA by more-specific serologic tests, which may be guided by the pattern(s) observed.
If ANA are detected by ELISA, then Antinuclear Antibody (ANA), HEp-2, IgG by IFA will be added. Additional charges apply
ANA identified by indirect fluorescence assay (IFA) using HEp-2 substrate and IgG-specific conjugate at a screening dilution of 1:80. Positive nuclear patterns reported include homogeneous, speckled, centromere, nucleolar, or nuclear dots. Positive cytoplasmic patterns reported include reticular/AMA, discrete/GW body-like, polar/golgi-like, rods and rings, or cytoplasmic speckled patterns. All positive results are reported with endpoint titers at no additional charge.
Antinuclear Antibodies (ANA), IgG by ELISA: ANA specimens are screened using enzyme-linked immunosorbent assay (ELISA) methodology. All ELISA results reported as Detected are further tested by indirect fluorescent assay (IFA) using HEp-2 substrate with an IgG-specific conjugate. The ANA ELISA screen is designed to detect antibodies against dsDNA, histones, SS-A (Ro), SS-B (La), Smith, Smith/RNP, Scl-70, Jo-1, centromeric proteins, and other antigens extracted from the HEp-2 cell nucleus. ANA ELISA assays have been reported to have lower sensitivities than ANA IFA for systemic autoimmune rheumatic diseases (SARD).
Negative results do not necessarily rule out SARD.
CPT Codes
86038; if reflexed, add 86039
LOINC
29950-3
Performing Lab
ARUP Laboratories
Collection
Synonyms
Anti-Nuclear Antibody (FANA), Body Fluid
ANA, Body Fluid
ANA IgG Screen
ANA Screen
Antinuclear Ab
ANA IFA RFLX
Performed
Sun-Sat
Reported
1-3 days
Ordering Recommendations
Aids in initial diagnosis of connective tissue disease.
Collect
Serum Separator Tube (SST).
Specimen Preparation
Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL)
Unacceptable Conditions
Non-serum, heat inactivated, grossly hemolyzed, or severely lipemic specimens.
Storage/Transport Temperature
Alternate specimen types run with a disclaimer:
1 mL CSF, pleural, pericardial, peritoneal, synovial or supraclavicular fluids.
Stability (from collection to initiation)
After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
Notes
ANA lacks diagnostic specificity, and is associated with a variety of diseases (cancers, autoimmune, infectious, and inflammatory conditions) and occurs in healthy individuals in varying prevalence. The lack of diagnostic specificity requires a confirmation of positive ANA by more-specific serologic tests, which may be guided by the pattern(s) observed.
If ANA are detected by ELISA, then Antinuclear Antibody (ANA), HEp-2, IgG by IFA will be added. Additional charges apply
ANA identified by indirect fluorescence assay (IFA) using HEp-2 substrate and IgG-specific conjugate at a screening dilution of 1:80. Positive nuclear patterns reported include homogeneous, speckled, centromere, nucleolar, or nuclear dots. Positive cytoplasmic patterns reported include reticular/AMA, discrete/GW body-like, polar/golgi-like, rods and rings, or cytoplasmic speckled patterns. All positive results are reported with endpoint titers at no additional charge.
Antinuclear Antibodies (ANA), IgG by ELISA: ANA specimens are screened using enzyme-linked immunosorbent assay (ELISA) methodology. All ELISA results reported as Detected are further tested by indirect fluorescent assay (IFA) using HEp-2 substrate with an IgG-specific conjugate. The ANA ELISA screen is designed to detect antibodies against dsDNA, histones, SS-A (Ro), SS-B (La), Smith, Smith/RNP, Scl-70, Jo-1, centromeric proteins, and other antigens extracted from the HEp-2 cell nucleus. ANA ELISA assays have been reported to have lower sensitivities than ANA IFA for systemic autoimmune rheumatic diseases (SARD).
Negative results do not necessarily rule out SARD.
Laboratories.