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Test Code LAB3540 ANA (Antinuclear Antibodies), Hep2 Substrate IFA with reflex to Titer and Pattern if positive

Important Note

Ordering Recommendation (Rheumatology):

Preferred confirmatory ANA test for autoimmune connective tissue diseases.

Test Name Alias

ANA | IFA ANA Blood Level | RNAAutoantibodies | ANA Titer: ANA Pattern | 1122 | ANA Hep2 IFA

Clinical Information

The ANA Hep2 IFA slide is screened at 1:80 dilutions. If titer is ≥ 1:80 a titer and pattern will be reported. Patterns reported include Homogeneous, Speckled, Nucleolar, Centromere, and SSA Ro. All positive results are reported with endpoint titers.

ANA (antinuclear antibodies) occur in patients with a variety of autoimmune diseases, both systemic and organ-specific. They are particularly common in systemic rheumatic diseases, which include lupus erythematosus (LE), discoid LE, drug-induced LE, mixed connective tissue disease, Sjogren syndrome, scleroderma (systemic sclerosis), CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) syndrome, polymyositis/dermatomyositis, and rheumatoid arthritis. 

The diagnosis of a systemic rheumatic disease is based primarily on the presence of compatible clinical signs and symptoms. The results of tests for autoantibodies including ANA and specific autoantibodies are ancillary. Additional diagnostic criteria include consistent histopathology or specific radiographic findings.

Cautions

Some patients without clinical evidence of an autoimmune disease or a systemic rheumatic disease may have a detectable level of antinuclear antibody (ANA). This finding is more common in women than men and the frequency of detectable ANA in healthy women over 40 years of age may approach 15% to 20%. ANA may also be detectable following viral illnesses, in chronic infections, or in patients treated with many different medications.

Collection Instructions

Specimen Collection: Blood

Container(s): Gold Top (Serum Separator-SST Gel)

Preferred Volume to Collect: 5.0 mL

Minimum Volume to Collect: 2.0 mL

Neonate Volume to Collect: 2.0 mL

Capillary collect ok: Yes

Microtainer acceptable: Yes

Collection Instructions:

  • After collection, gently invert tube 8-10 times.
  • Specimen should be processed within 2 hours – See Processing Instructions.

Processing Instructions (Laboratory, Outpatient or Off-site collection)

Processed Specimen: Serum

Centrifuge/Spin: Yes

Aliquot: Yes

Processing Instructions:

  • Allow blood to clot for 30 minutes in a vertical position and centrifuge within 2 hours.
  • Aliquot serum into screw top plastic transport tube.

Transport Temperature: Ambient

Rejection Criteria

Specimen not centrifuged within 2 hours

Reflex Information

Reflex approved by Medical Executive Committee. Please see link: Reflex Testing Document

Specimen Stability

Ambient: 8 hours

Refrigerate: 7 days

Frozen: 1 month

Retention: 7 days, positive specimens are frozen for 30 days.

Test Frequency

Performed 3x per week

Turn around time 1 - 4 days

Reference Range

ANA Hep2 <1:80

Performing Department

IMMUNOCHEMISTRY

Performing Department Laboratory Location

Spectrum Health Regional Laboratory, Grand Rapids, MI

Methodology

ANA Hep2 slide IFA

 

CPT

86038

86039 if reflex

CDM Code

4088897

Epic Test ID

1230100353

Interface Order Alias

11778

Interface Information

Order: 11778

Result: 21719  - Antinuclear Ab

If reflex

20029 - ANA Pattern

20030 - ANA Titer

Mayo Access Code

SHO11778

LOINC

Antinuclear Ab: 9423-5

ANA Titer: 5048-4

ANA Pattern: 13068-2

Reviewed Date

5/30/2019