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Nuclear Antibody (ANA) by IFA, IgG
0050639
Ordering Recommendation

Preferred ANA screening test for connective tissue disease.

Mnemonic
ANA-IFA
Methodology
Semi-Quantitative Indirect Fluorescent Antibody
Performed
Sun-Sat
Reported
1-3 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
 
Collect
Serum separator tube. 
Specimen Preparation
Separate serum from cells ASAP. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.15 mL) 
Storage/Transport Temperature
Refrigerated. 
Unacceptable Conditions
Plasma. Contaminated, hemolyzed, or severely lipemic specimens. 
Remarks
 
Stability
After separation from cells: Ambient 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles) 
Reference Interval
Less than 1:40
Interpretive Data
Anti-nuclear antibodies (ANA) are seen in a variety of systemic rheumatic diseases and are determined by indirect fluorescence assay (IFA) using HEp-2 substrate with an IgG-specific conjugate. ANA titers less than or equal to 1:80 have variable relevance while titers greater than or equal to 1:160 are considered clinically significant. These antibodies may precede clinical disease onset; however, healthy individuals and those with advanced age have been reported to be positive for ANA. When observed, one of the five basic patterns is reported: homogeneous, peripheral/rim, speckled, centromere, or nucleolar. If cytoplasmic fluorescence is observed, it is noted. IFA methodology is subjective and has occasionally been shown to lack sensitivity for anti-SSA/Ro antibodies. Negative results do not necessarily rule out the presence of SSc. If clinical suspicion remains, consider further testing for U3-RNP, PM/Scl, or Th/To antibodies associated with SSc.

Note
When cell culture substrates (HEp-2 cells) are used, the ANA incidence is greater than: 90 percent in systemic lupus erythematosus (SLE), 80 percent in Sjögren syndrome and scleroderma, and 40 percent in juvenile idiopathic arthritis.

ARUP uses anti-human IgG-specific conjugate since many (20-77 percent) healthy individuals have low levels (1:40 to 1:80) of ANA IgM. Conversion of ANAs from IgM to IgG generally precedes the onset of autoimmune disease states. If clinical presentation is inconsistent with the ANA IFA result, consult ARUP for alternative testing.
Components
Component Test Code*Component Chart NameLOINC
0050639Anti-Nuclear Antibody (ANA), IgG by IFA56634-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • ANA
  • Antinuclear Antibodies
  • Antinuclear Antibody
  • FANA
  • Fluorescent Antinuclear Antibodies