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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

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Item Value
Available Stat? No
Test code ANA
Performed by? Microbiology
Sendout? no
Price range $$
In House Availability Test run 2 times each week; Monday and Thursday.
Principle The ANA test is an indirect fluorescent antibody procedure for the detection and semi-quantitation of human antinuclear autoantibodies. Human epithelial (HEp-2) cells are used for this test. Observation of a specific pattern of fluorescence on the HEp-2 cells indicates the presence of autoantibodies in the patient's serum. Titers are done on positive specimens.

Specific ANA patterns are suggestive of the following autoantibodies:

1. Homogeneous (diffuse) - autoantibodies to native DNA, histones or deoxyribonucleoprotein

2. Rim (peripheral) - autoantibodies to DNA

3. Speckled - autoantibodies to Sm, RNP, Sci-70, SSA, SSB or unidentified antigens

4. Nucleolar - autoantibodies to 4-6S RNA
Interpretation The test for antinuclear antibodies (ANA) is a good screening test for autoimmune disorders. For example, more than 95% of patients with systemic lupus erythematosus (SLE) will have a positive ANA test using human HEp-2 cells. In addition, most patients with scleroderma or mixed connective tissue will have a positive ANA. However, a positive ANA result is not specific for autoimmune disease, since patients with viral infections, chronic inflammatory processes, carcinoma, rheumatoid arthritis, drug-induced lupus, and older persons with no evidence of autoimmune disease can have a positive ANA. Staining patterns reported for patients with positive ANA tests suggest the presence of specific autoantibodies and guide selection of further testing to identify them; e.g., anti-dsDNA, anti-Ro, or anti-La. The presence of specific autoantibodies in conjunction with clinical presentation can be used for diagnosis of autoimmune diseases such as SLE or scleroderma. Sera from patients undergoing successful therapy for autoimmune disorders may be negative for ANA.
Container type gold top gel tube (red top non-gel tube is also acceptable).
Amount to Collect 3 mL
Sample type Clotted Blood
Normal range Negative < 1:40.
Synonyms ANA;
Stability 3 days at 4°C. (Serum stable longer at -20°C.)
Additional information REQUISITION: Blood/Serum - Main Laboratory
References 1. Kavanaugh A, Tomar R, Reveille J, et al.: Guidelines for Clinical Use of the Antinuclear Antibody Test and Tests for Specific Autoantibodies to Nuclear Antigens. Arch Pathol Lab Med. 2000 (Jan) 124: 71-81.

2. Detrick, B, Hamilton, RG, Folds, JD, eds. 2006. Manual of Clinical Laboratory Immunology, 7th Ed. ASM Press, Washington, DC.
CPT coding 86038
Last Updated 12/29/2008 2:25:28 PM
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