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Interpretive Handbook

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Test 86038 :
Antinuclear Antibodies (ANA), HEp-2 Substrate, Serum

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Antinuclear antibodies (ANA) occur in patients with various autoimmune diseases, both systemic and organ specific, but they are particularly common in systemic rheumatic diseases (SRD). The SRDs include systemic lupus erythematosus, discoid lupus erythematosus, drug-induced lupus erythematosus, mixed connective tissue disease, Sjogren’s syndrome, scleroderma (systemic sclerosis), CREST syndrome (calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia), rheumatoid arthritis, and polymyositis or dermatomyositis. ANA can be detected by a number of various technologies, including indirect immunofluorescence, enzyme immunoassays, and bead-based multiplex immunoassays.

Useful For Suggests clinical disorders or settings where the test may be helpful

Diagnosis of autoimmune diseases

Interpretation Provides information to assist in interpretation of the test results

Midbody is a rare pattern found to occur in scleroderma and Raynaud’s phenomenon.

 

Cytoplasmic Staining is associated with antibodies that may be derived from multiple cytoplasmic proteins including Jo-1 (20%-40% polymyositis), ribosome P (10%-15% systemic lupus erythematosus [SLE]), and mitochondrial M2 (90% PBC and 40% scleroderma).

  

Other Cytoplasmic Patterns

 

Mitotic Spindle pattern is nonspecific and can be seen in a variety of disease states; has no known clinical significance.

 

Centrosome (Centriole) is a rare pattern that may be seen in patients with nonspecific rheumatic diseases and some chronic post-viral syndromes.  

 

Golgi Apparatus is observed in patients with SLE, Sjogren's syndrome, mixed connective tissue disease, and is seen in 30% to 80% of rheumatoid arthritis.

 

If the anti-nuclear antibody screen is positive a titer will be performed if indicated. Low titers of antinuclear antibodies reactivity are observed in approximately 5% of apparently healthy individuals and the incidence increases with increasing age. The results of this test must be interpreted in the context of the clinical picture. Interpretive comments are provided when applicable.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test is a laboratory diagnostic aid and by itself is not diagnostic. Positive results with this test may occur in apparently healthy people. Therefore, the results of this test must be interpreted by a medical authority in the context of the patient's total clinical condition.

 

Sera from systemic lupus erythematosus patients undergoing steroid therapy may give negative results.

 

No definitive association between the pattern of nuclear fluorescence and any specific disease state is intended with this test.

 

Many drugs (eg, hydralazine, procainamide) may induce antinuclear antibodies production.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

<1:40 (Negative)

Clinical References Provides recommendations for further in-depth reading of a clinical nature

This test is a laboratory diagnostic aid and by itself is not diagnostic. Positive results with this test may occur in apparently healthy people. Therefore, the results of this test must be interpreted by a medical authority in the context of the patient's total clinical condition.

 

Sera from systemic lupus erythematosus patients undergoing steroid therapy may give negative results.

 

No definitive association between the pattern of nuclear fluorescence and any specific disease state is intended with this test.

 

Many drugs (eg, hydralazine, procainamide) may induce antinuclear antibodies production.


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