Test Directory

Anti-Nuclear Antibody

Containers - Adult

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Sarstedt Monovette Serum Gel Tube (Brown Cap)
Volume Range

​4.9mls

Additive per Container

​Gel

Containers - Child

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Teklab Small White Cap
Volume Range

​Minimum 1ml

Additive per Container

​None

Reference ranges

Results are reported as 'Negative' or 'Positive' with the antibody titre on HEp2 cells reported as:

1:80 (low level) to >1:640 (strongly positive)

A large number of staining patterns have been described but only the following most common patterns are reported here.

Homogeneous* Indicates presence of antibodies to dsDNA, ssDNA or histones. Suggestive of SLE but also found in other CTDs, drug-induced lupus and autoimmune liver disease.

Speckled ** Caused mainly by antibodies to Sm, RNP, Ro and La. Pattern found in SLE, mixed connective tissue disease (MCTD) and SS but also other CTDs.

Nucleolar** Caused by many autoantibodies including PM-Scl, Th/To, RNA Polymerase III, RNA and RNA Helicase. High titre associated with scleroderma, low titre found in other CTDs.

Centromere*** Most frequently found in CREST (Clacinosis, raynaud's phenomenon, Oesophageal dysmotility, Sclerodactyly and Telangectasia) variant of Progressive Systemic Sclerosis but also in Sjogren's disease and Raynaud's (where it is likely to indicate future CREST). Its presence in Primary Biliary Cirrhosis is indicative of a more severe disease progression.

Nuclear Membrane *** Found rarely in a variety of connective tissue diseases.

 

* A positive homogeneous pattern of 1:80 or greater (in any combination) will trigger a dsDNA ELISA.

** A positive speckled and/or nucleolar pattern of 1:160 or greater (in any combination) will trigger an ENA screen ELISA.

*** A positive centromere, nuclear dots or nuclear membrane staining pattern will trigger an Anti-Mitochondrial antibody +/- Mitochondrial M2 ELISA test.

Laboratory Site

RIE
51 Little France Crescent
Old Dalkeith Road
Edinburgh
EH16 4SA
Telephone: 0131 536 1000

How to request

​Trak, ICE, Clinical Immunology request form.

Availability

Normal working hours 8.00am-5pm Mon-Fri.

Anticipated turnaround

 

​The Turnaround time for this test is 2 weeks (10 working days)

What happens if the result is positive or abnormal

Reviewed and authorised by Consultant Immunologist.

General additional information

The major reason for ordering the ANA test is as an aid to the diagnosis of a range of connective tissue diseases (CTDS) including Systemic Lupus Erythematosus (SLE), Sjogren's syndrome and Systemic Sclerosis (SS). Anti-nuclear antibodies, particularly at low titres may also be seen following infection, with certain drug therapies and in a number of other autoimmune/inflammatory conditions, and are found frequently in the normal, especially elderly, population.
 
Indirect immunofluorescence (IIF) is performed on fixed HEp2 cells. the titre of antibody and the pattern of staining is reported. This cell line has large nuclei which allows better definition of the staining pattern and there are also significant numbers of dividing cells allowing detection of autoantibodies to cell cycle specific antigens such as centromere proteins.