Antinuclear antibody panel
ANA; ANA panel; ANA reflexive panel; SLE - ANA; Systemic lupus erythematosus - ANAThe antinuclear antibody panel is a blood test that looks at antinuclear antibodies (ANA).
Antibodies
An antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include micr...
Read Article Now Book Mark Article- ANA are antibodies produced by the immune system that bind to the body's own tissues.
- The antinuclear antibody test looks for antibodies that bind to a part of the cell called the nucleus.
If the test is positive, a panel of tests may be done to identify specific antibodies. This is the ANA antibody panel.
How the Test is Performed
Blood is drawn from a vein. Most often, a vein on the inside of the elbow or the back of the hand is used. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.
Next, the provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.
Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.
In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.
Depending on the laboratory, the test may be processed in different ways. One method requires a technician to examine a blood sample under a microscope using ultraviolet light. The other uses an automated instrument to record the results.
How to Prepare for the Test
No special preparation is needed. However, certain drugs, including birth control pills, procainamide, and thiazide diuretics, affect the accuracy of this test. Make sure your provider knows about all the medicines you take.
How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain. Others may feel only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the Test is Performed
You may need this test if you have signs of an autoimmune disorder, such as unexplained symptoms including arthritis, rashes, fevers or chest pain. Suspected systemic lupus erythematosus may be the most common reason why the test is done.
Arthritis
Arthritis is inflammation or degeneration of one or more joints. A joint is the area where 2 bones meet. There are more than 100 different types of...
Read Article Now Book Mark ArticleSystemic lupus erythematosus
Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It c...
Read Article Now Book Mark ArticleNormal Results
ANA test results are most often reported in 2 parts: the level or titer and the pattern.
- Titres are reported in ratios, most often 1:40, 1:80, 1:160, 1:320, and 1:640. Some, but not all labs will report a titre above 1:160 as positive.
- Patterns that are reported include, homogeneous, speckled, centromere, and others.
Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.
The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.
Further tests can be run on blood with a positive ANA test to get more information.
What Abnormal Results Mean
A positive ANA is not enough to make a diagnosis. To diagnose any disease related to a positive ANA, it is important to have:
- A full assessment by a doctor who specializes in any of the illnesses listed below
- Further antibody testing, for certain illnesses
To make the diagnosis of SLE, the following must be present
- Certain clinical features
- Positive ANA results (a lack of ANA makes the diagnosis much less likely)
- Certain specific ANA antibodies, which help to confirm the diagnosis
Other disorders besides SLE where positive ANA results strongly suggest a diagnosis include:
- Systemic sclerosis (scleroderma)
Systemic sclerosis (scleroderma)
Scleroderma is a disease that involves the buildup of fibrous tissue in the skin and elsewhere in the body. It also damages the cells that line the ...
Read Article Now Book Mark Article - Sjögren syndrome (primary)
Sjögren syndrome (primary)
Sjögren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The...
Read Article Now Book Mark Article - Myositis (inflammatory muscle disease)
Myositis (inflammatory muscle disease)
Myositis is an inflammation or swelling of the muscles. It is most often caused by injury, infection, medicines, or an autoimmune disorder. Dermatom...
Read Article Now Book Mark Article - Drug-induced lupus erythematosus
Drug-induced lupus erythematosus
Drug-induced lupus erythematosus is an autoimmune disorder that is triggered by a reaction to a medicine.
Read Article Now Book Mark Article
Other common diseases that ANA testing can help diagnose include:
- Mixed connective tissue disease
Mixed connective tissue disease
In a class of diseases known as autoimmune disorders, the body's immune system attacks its own tissues. Some of these diseases are similar to each o...
Read Article Now Book Mark Article - Polymyositis/dermatomyositis
- Autoimmune hepatitis
- EB virus
- Hepatitis C
- HIV
- Lymphomas
- Rheumatoid arthritis
Rheumatoid arthritis
Rheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It is a long-term disease. It can also aff...
Read Article Now Book Mark Article - Thyroid disease
- Parvovirus
Risks
Veins and arteries vary in size from one person to another, and from one side of the body to the other. Obtaining blood from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight, but may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Considerations
The ANA can be positive in relatives of people with SLE who do not have SLE themselves.
There is a very low chance of developing SLE at some time later in life if the only finding is a low titer of ANA.
References
American College of Rheumatology website. Antinuclear antibodies (ANA). rheumatology.org/patients/antinuclear-antibodies-ana. Updated February 2023. Accessed October 03, 2023.
Peng SL, Craft JE. Anti-nuclear antibodies. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 58.
von Mühlen AC, Chan EKL, Ceribelli A, Fritzler MJ. Clinical and laboratory evaluation of systemic autoimmune rheumatic diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 53.
Blood test - illustration
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Blood test
illustration
Blood test - illustration
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Blood test
illustration
Review Date: 1/25/2023
Reviewed By: Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 10/03/2023.