Ordering Recommendation

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

Mnemonic
DNA 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.
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. 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 1:10

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://www.arupconsult.com/Topics/AutoimmuneDz/ConnectiveTissueDz/index.html.

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)