Positive screening results reflex to a titer at an additional charge.

If positive, a pattern including the following will be reported out along with a titer up to ≥2560. If cytoplasmic staining is present, it will be noted:

• Homogenous
• Speckled
• Dense fine speckled
• Centromere
• Spindle
• Nucleolar
• Nuclear dots

Circulating autoantibodies directed against nuclear antigens (ANA) can be titered and identified by pattern by using indirect fluorescent antibody (IFA) procedures. The ANA titer is a diagnostic aid only. Low titer positives may occur in healthy people, therefore, a positive titer must be interpreted in the context of the patient’s clinical picture. Multiple antibodies may be present, making individual antibody identification difficult. Serial dilutions may aid in pattern determination.

Excessive hemolysis or lipemia may produce non-specific background staining which may interfere with the interpretation of the reaction

Gold serum separator (SST) tube

Immediatley following collection, mix sample by gently inverting 5 times

1. Allow sample to clot for a minimum of 30 minutes
2. Spin within two (2) hours of sample collection

Gold serum separator (SST) tube

Red serum vial/tube - 5 mL

Red/grey serum separator (SST) vial/tube, 10 mL

1. Allow sample to clot
2. Spin
3. Transfer serum to a False bottom plasma/serum transport vial/tube (AHL), labelled as serum, within two (2) hours of sample collection

False bottom plasma/serum transport vial/tube (AHL)

Red/grey serum separator (SST) vial/tube, 10 mL

Refrigerated (preferred) - 7 days

Frozen (OK)

• Improper labels (unlabeled or mislabeled)
• Hemolysis (some procedures)
• Improper anticoagulant or ratio
• Delay in transport
• Improper storage temperature affecting results
• Improper container
• Leaking container resulting in compromised specimen
• Quantity not sufficient (QNS)

Immunofluorescence Antibody (IFA) on Hep-2 Substrate, IgG

Negative

The most common autoantibodies and their associated ANA pattern are listed below. Some patterns are more specific to the disease process involved than others. For example, the homogeneous, nucleolar, and centromere patterns are fairly specific for SLE, scleroderma, and CREST variant of scleroderma respectively. On the other hand, the speckled pattern is the most nonspecific. Also note that patients undergoing successful treatment may be negative for ANA.

Drugs that have been reported to induce SLE include: Salicylic acid, mephenytoin, carbamazepine, ethosuximide, phenytoin, primidone, trimethadione, chlorpromazine, chlorthalidone, D-penicillin, griseofulvin, hadrallazine, isoniazid, levodopa, methyldopa, oral contraceptive, phenylbutazone, practolol, procainamide, quinidine, streptomycin, sulphonamides, tetracycline, and many more