Anti-nuclear antibody by IFA-12467

Test info

  
Anti-nuclear antibody by IFA
  
12467
  
LAB12467
  
ANA
  
ANA
FANA
  

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

Specimen

  
Serum
  
  
1.0 mL
  
0.5 mL
  

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)

Performance

  
AHL - Immunology: I
  
Mo - Fr
  
1 - 3 days
  

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

Clinical and Interpretive info

  

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.

Autoantibody/Antigens recognized

ANA pattern

Disease association

Double & Single Stranded DNA

Homogeneous/Rim

SLE & low levels may occur in other rheumatic disease

Histones

Homogeneous/Rim

Drug-induced lupus, SLE

Deoxynucleoprotein

Homogeneous/Rim

Drug-induced lupus, SLE

Smith(Sm)

Speckled

Diagnostic of SLE

Nuclear RNP

Speckled

High titer-Mixed connective tissue disorder/SLE

SS-A (Ro)

Speckled Negative (low titer)

Sjogren’s’ syndrome, SLE

SS-B (La)

Speckled

Sjogren’s syndrome

Centromere

Centromere

CREST variant of Scleroderma

RNA Polymerase I

Nucleolar

Scleroderma- high prevalence

Fibrillarin

Nucleolar

Scleroderma

DNA Topoisomerase I (Scl-70)

Nucleolar

Scleroderma

PM-ScL

Nucleolar

Polymyositis

Mitotic Spindle Apparatus, NuMA

Spindle (MSA)

Carpal tunnel syndrome, SLE, Sjogren’s

Jo-1

Cytoplasmic Nucleolus

Polymyositis

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

Billing

  
86038 - Screen

Additional CPT codes (if appropriate):
86039 - Titer

Tracking

  
11/30/2001
  
02/02/2022
  
01/11/2024