Laboratory:
Chemical Pathology
Referral Laboratory:
MiChart Name:
ANA by IFA, HEp-2000 Substrate (Rheumatology Patients Only)
MiChart Codes:
LAB147
Soft Order Code:
NAB
Synonyms:
ANA by IFA HEp-2 ANA
Container:
SST tube
Normal Volume:
0.5 mL serum
Minimum Volume:
0.5 mL serum
Offsite Collection:
Collect specimen in SST tube. Centrifuge, aliquot serum into a plastic vial and refrigerate.
Onsite Collection (Michigan Medicine Hospitals Only):
Available only by special request (e.g., rheumatology patients). See also Antinuclear Antibody Screen by Multiplexed Immunoassay. Collect specimen in SST tube.
Days Set Up:
Monday - Friday
Analytic Time:
Screen: 24 hours; Titer: 48 hours
Reference Range:
*Reference ranges may change over time. Please refer to the original patient report when evaluating results.
Screen: Negative. Titer: <1:80.
Test Usage:
Initial screening test for various autoimmune disease including SLE, rheumatoid arthritis, scleroderma, and mixed connective tissue disease. A titer/pattern will be performed on all positive screens. Any degree of positivity in children suggests possibility of SLE or JRA and the more specific tissue ANA will be run on all children less than 18 years of age.
Test Limitations:
Positive screens are not unusual in elderly or patients with infectious mononucleosis. Various medications can induce a "lupus-like" condition and elevated ANA titers, which usually decrease following removal of the drug. Test sensitivity is 1:80.
Test Methodology:
Indirect Fluorescence Antibody (IFA), HEp-2000 substrate
Additional Information:
If the screen is positive, a titer will be performed at an additional charge. If the Hep-2000 ANA titer is 1:80 or greater with a homogeneous, speckled, nucleolar, or atypical nuclear matrix pattern in children less than 18 years of age, the more specific tissue ANA will be performed at an additional charge. By ordering this test the clinician acknowledges that additional reflex testing will be performed and billed at a separate additional charge if indicated. The indirect immunofluorescent test has three elements to consider in the result: 1) Positive or negative fluorescence, 2) The titer (dilution) to which fluorescence remains positive, and 3) The pattern of nuclear fluorescence (reflecting specificity for various disease). A negative ANA usually rules out SLE. However, if the ANA is negative and the clinical picture suggests SLE or Sjogren's Syndrome, the physician may wish to order SS-A/RO(See Extractable Nuclear Antibody). The ANA may be positive in other autoimmune disorders and in 5-15% of normal people. It is highly recommended that follow-up testing be performed on positive ANA samples.
LOINC:
42254-3 NAB, 5048-4 NAB TITER, NAB PATTERN 13068-2
CPT Code:
86038
Fee Code:
30914
Reflex CPT:
86039
Reflex Fee Code:
21937
Alternate Specimen:
Red top tube.
Rejection Criteria:
Fluid and plasma specimens are not acceptable.
Test ID:
124