Laboratory Test Information Guide

Details for Anti Nuclear Antibody

Test Name: Anti Nuclear Antibody
Alternate Name(s): ANA
Laboratory: Clinical Immunology
Specimen Type: Serum (preferred) from a 5 mL Gold top Vacutainer tube or 6 mL Red top Vacutainer tube

Pediatric:
0-2 years: Red 0.5pk.
2-10 years: 2 mL Red top

EDTA, heparin or citrated plasma will also be accepted.
Other fluids will not be accepted.
Collection Information: Minimum volume of serum required is 0.5 mL.
Requisition: GENERAL LABORATORY REQUISITION
Test Schedule: Batch Analysis
Turnaround time from when specimen
is received in testing laboratory:
 
Routine
5 days
Stat
N/A
 
Reference Range: Negative <1:80
Effective Date: 2010-01-11
Revised Date: 2018-02-09
Critical Value:  
Interpretive Comments: The following IFA patterns are reported as either negative or positive with a titre.

Homogenous
DFS
Speckled
Nucleolar
Centromere
Few Nuclear Dots
Multiple Nuclear Dots
Nuclear membrane
PCNA-like
CENP F-like
Cytoplasmic Fibrillar
Cytoplasmic Lysosome
Cytoplasmic Dense Fine Speckled
Cytoplasmic Fine Speckled
Cytoplasmic Golgi-like
Cytoplasmic Reticular
Cytoplasmic Rods and Rings
Mitotic

Depending on which pattern is positive, ANA samples will be followed up by Immunoblot testing with the following:

Chromosome Positive
Anti dsDNA
Anti Nucleosomes
Anti Histones
Anti DFS70

ENA-Profile Plus 1
Anti nRNP/Sm
Anti Sm
Anti SS-A
Anti SS-B
Anti Ro-52
Anti Scl-70
Anti Jo-1

Nucleoli Profile
Anti Scl70
Anti CENP-A
Anti CENP-B
Anti RP11
Anti RP155
Anti Fibrillarin
Anti NOR90
Anti Th/To
Anti PM-Scl100
Anti PM-Scl75
Anti Ku
Anti PDGFR
Anti Ro-52

Cytoplasmic Profile
AMA-M2
Anti M2-3E
Anti Ribosomal P-protein
Anti Jo-1
Anti SRP
Anti PL-7
Anti PL-12
Anti EJ
Anti OJ
Anti Ro-52

Liver Profile
AMA-M2
Anti M2-3E
Anti Ro-52
Anti Sp100
Anti PML
Anti gp210
Anti LKM-1
Anti LC-1
Anit SLA/LP

Immunoblot results will be reported as either negative or positive for specific antibodies as the following.

(+) Borderline
1+ Positive
2+ Positive
3+ Strong Positive.

Interpretative comments for each of positive specific antibodies will be provided on reports.

The ANA test is a diagnostic aid only. Lower titre positive results may occur in apparently healthy people. Therefore, the results of this test must be interpreted in the context of the patient’s total clinical presentation.

Positive ANA’s are seen in a small percentage of patients with infectious and/or neoplastic diseases. Negative ANA’s are seen in a small percentage of autoimmune patients.
Special Processing:  
Comments: ANA should not be used to monitor disease activity. Positive ANA other than anti-dsDNA NEVER should be repeated. If ANA was tested positive previously, repeat testing will not be processed.

Anti-dsDNA may correlate with disease activity and positive results can be repeated 1-3 months for active disease and 6-12 months for less active disease. Repeat testing for Anti-dsDNA within 1 month will not be processed.

If ANA is negative or borderline positive (1:80), repeat testing is allowed only if the patient has developed new symptoms of SARD and the minimum retesting interval is limited to 6 months. If ANA was negative of borderline positive, repeat testing within 6 months will not be processed.

Positive Speckled pattern will not be followed for children < 18 years of age.
Method of Analysis: Indirect fluorescence assay (IFA) for screening. Immunoblot for confirmation.
ELISA for quantification of anti-dsDNA.
Critical Information Required:  
Storage & Shipment: Store serum or plasma at 2-8°C for up to 14 days.
For longer storage, store at –20°C.
System Codes: 
Cerner
ANA
 
Referred To:  

Questions? Comments? Contact Laura Gopaul