Ordering Recommendation

Secondary screening for systemic lupus erythematosus (SLE) based on ANA results.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation
Collect

Serum separator tube.

Specimen Preparation

Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.15 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Plasma. Cerebral spinal fluid. Contaminated, hemolyzed, or severely lipemic specimens.

Remarks
Stability

After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 month (avoid repeated freeze/thaw cycles)

Methodology

Semi-Quantitative Indirect Fluorescent Antibody (IFA)

Performed

Sun-Sat

Reported

1-3 days

Reference Interval

Less than 1:10

Interpretive Data

Positivity for anti-double stranded DNA (anti-dsDNA) IgG antibody is a diagnostic criterion of systemic lupus erythematosus (SLE). The presence of the anti-dsDNA IgG antibody is identified by IFA titer (Crithidia luciliae indirect fluorescent test [CLIFT]). CLIFT is highly specific for SLE with a sensitivity of 50-60 percent.

Some patients with early or inactive SLE may be positive for anti-dsDNA IgG by ELISA but negative by CLIFT. If the CLIFT result is negative but the patient has a positive ELISA and clinical suspicion remains, consider antinuclear antibody (ANA) testing by IFA. Additional information and recommendations for testing may be found at https://arupconsult.com/content/connective-tissue-diseases.

Compliance Category

FDA

Note

Double Stranded DNA (dsDNA) antibodies (1:10 or greater) are found in 50-60 percent of systemic lupus erythematosus (SLE), 20-30 percent in Sjögren syndrome, 20-25 percent in mixed connective tissue disease (MCTD), and less than 5 percent in progressive systemic sclerosis (PSS). High titers of antibody to native (double stranded) DNA are specific for SLE.

Hotline History

N/A

CPT Codes

86256

Components

Component Test Code* Component Chart Name LOINC
2002692 Double-Stranded DNA (dsDNA) Ab IgG IFA 58466-4
* 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

  • anti-DNA
  • Antibody to ds-DNA
  • Crithidia luciliae indirect fluorescent test (CLIFT)
  • Double stranded DNA antibody
  • Native double-stranded DNA antibody
Double-Stranded DNA (dsDNA) Antibody, IgG by IFA (using Crithidia luciliae)