Laboratory: Clinical Immunology
Test Name:
ANTI-NUCLEAR ANTIBODIES - (S)
Test Code: HEP2
Clinical Information:
Alternate Names:
ANA
ANA IFA
ANA Screen
Antinuclear Antibody
HEP-2
Fluorescent Antinuclear Antibodies

Evaluation of patients suspected of having systemic autoimmune rheumatic disease (ANA-associated rheumatic diseases or connective tissue disease) or organ-specific autoimmune diseases such as autoimmune liver diseases.

DO NOT order dsDNA as a routine screen with ANA.

Visit the International Consensus on Antinuclear Antibody Patterns website for additional information about pattern and disease/antigen associations.
Collection Devices:
Preferred Device:
1 - Serum Separator (SST) Tube(s) - Full Tube Collection
Specimen Required:
Serum: 1.0 mL

Refrigerated: 14 days
Frozen: 30 days
Referral:
Serum: 1.0 mL

Separate serum and ship refrigerated, or frozen if greater than 7 days from time of collection.

Testing Laboratory: St. Boniface Hospital Immunology Laboratory
Requisition:
Reference Values:
Reference Intervals:
Negative <1:80 Titre
 
A negative result does not necessarily exclude autoimmune disease.  Positive results should not be interpreted in isolation and must be correlated with relevant clinical findings. 
Note: 10% of normal individuals will have a positive ANA at 1:80 titre.

Method of Analysis: 
The indirect immunofluorescence test (IFA) is the gold standard for the
determination of antibodies against nuclear antigens (ANA), including cytoplasmic components.  HEP-20-10 cell substrate is utilized (HEP-2 cells optimised to form more mitotic stage cells).
Serum samples are initially screened at a 1:80 dilution.

EUROIMMUN Hep-20-10 EUROPattern Instructions for the indirect immunofluorescence test, FC_1522_A_UK_C16.doc Version 11/01/2017.
Availability:
Weekdays
TAT: Within 4 days
See Also:
More Information:
Positive results will be accompanied by a pattern (Nuclear,Cytoplasmic, Mitotic) and titre.
 
Reflex testing will be performed on titres ≥ 160 as per the table below:
ANA Pattern (≥ 1:160 Titre) dsDNA Profile
NUCLEAR PATTERN
Homogeneous  X  X
Speckled  X  X
Centromere    X
Nucleolar    X
PCNA    X
Cytoplasmic Pattern
Cyto-Speckled    X
Cyto-AMA    X

ANA Profile will be performed by Line Immunoassay and will include nRNP/Sm, Sm, SS-A, Ro-52, SS-B, Scl-70, PM-Scl, Jo-1, CENP B, PCNA, Nucleosomes, Histones, Rib P Protein, AMA-M2 and DFS70.