Anti-Nuclear Antibodies (ANA), IgG by ELISA with Reflex to ANA, IgG by IFA
Ordering Recommendation

Aids in initial diagnosis of connective tissue disease.

Qualitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody
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
Serum separator tube. 
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) 
Storage/Transport Temperature
Unacceptable Conditions
Non-serum, heat inactivated, grossly hemolyzed and severly lipemic specimens. 
After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles) 
Reference Interval
Effective November 19, 2012
Components Reference Interval
Anti-Nuclear Antibodies (ANA), IgG by ELISANone Detected
Nuclear Antibody (ANA) by IFA, IgGLess than 1:40

Interpretive Data
Anti-Nuclear 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, histone, SS-A (Ro), SS-B (La), Smith, snRNP/Sm, Scl-70, Jo-1, centromere, and an extract of lysed HEp-2 cells. ANA ELISA assays have been reported to have lower sensitivities for antibodies associated with nucleolar and speckled ANA-IFA patterns.

ANA are not specific for systemic lupus erythematosus (SLE) but are found in a variety of rheumatic or connective tissue diseases. 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 Sjogren syndrome and scleroderma, and 40 percent in juvenile idiopathic arthritis.

ARUP uses anti-human IgG 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.

If ANA are Detected by ELISA, then ANA by IFA titer will be added. Additional charges apply.
CPT Code(s)
Component Test Code*Component Chart NameLOINC
0050080Anti-Nuclear Ab (ANA), IgG by ELISA29950-3
* 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.
  • ANA IgG Screen
  • ANA Screen
  • Antinuclear Ab