|Values are valid only on day of printing.|
Evaluation of patients with signs and symptoms compatible with connective tissue diseases
The testing algorithm is useful in the initial evaluation of patients and performs best in clinical situations in which the prevalence of disease is low.
If antinuclear antibodies (ANA) HEp-2 substrate screen is positive, then ANA multiple will be performed at an additional charge.
If ANAB is <1:160, the cascade will stop and results will be reported.
If ANAB is > or =1:160, then DNA double-stranded antibody, ribosome P antibody, and antibody to extractable nuclear antibody will be performed at an additional charge.
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 (SLE), discoid lupus erythematosus, drug-induced lupus erythematosus, mixed connective tissue disease, Sjogren syndrome, scleroderma (systemic sclerosis), CREST syndrome (calcinosis, Raynaudâ€™s phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia), rheumatoid arthritis, and polymyositis or dermatomyositis.
Autoantibodies with High Specificity for Individual Connective Tissue Diseases
Scl 70 antibodies (topoisomerase 1)
Jo 1 antibodies (histidyl tRNA synthetase)
SSA/Ro and SSB/La antibodies
RNP antibodies (in isolation)
Ribosome P antibodies
Low titers of ANA reactivity are observed in approximately 5% of apparently healthy individuals and the incidence increases with increasing age. Titers > or =1:160 are generally considered to be clinically significant and more closely related to the presence of active disease. The results of this test must be interpreted in the context of the clinical picture.
Interpretive comments are provided.
See individual test IDs for additional information.
This test is a laboratory diagnostic aid and by itself is not diagnostic. Positive results of 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.
1. Bradwell AR, Stokes RP, Johnson GD: Atlas of HEp-2 patterns. San Diego, CA. The Binding Site, 1995, pp 9, 10, 19, 38-54
2. Fritzler MJ: Immunofluorescent antinuclear antibody test. In Manual of Clinical Laboratory Immunology. Fourth edition. Edited by NR Rose, EC De Macario. Washington, DC, ASM Press, 1992, pp 724-727
3. McCarty GA, Valencia DW, Fritzler MJ: Antinuclear antibodies. In Contemporary Techniques and Clinical Application to Connective Tissue Diseases. Oxford University Press, Inc, 1984, pp 3
4. Stites DP, Terr AI: Basic and Clinical Immunology. Seventh edition. Edited by DP Stites, AI Terr. Norwalk, CT. Appleton and Lange, 1991, pp 220