ARUP's Laboratory Test Directory

Anti-Nuclear Antibodies (ANA), IgG by ELISA with Reflex to ANA, IgG by IFA : 0050080

Mnemonic: ANA

Methodology: Qualitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody
Performed: Sun-Sat
Reported: 1-3 days
Specimen Required: Collect: Serum separator tube.

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL)

Storage/Transport Temperature: Refrigerated.

Unacceptable Conditions: Plasma or urine. Contaminated, grossly hemolyzed, heat-inactivated, severely lipemic specimens or inclusion of fibrin clots.

Stability (collection to initiation of testing): After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
Reference Interval:
Effective November 19, 2012
 
Test Number Components Reference Interval
 Anti-Nuclear Antibodies (ANA), IgG by ELISA None Detected
0050639 Nuclear Antibody (ANA) by IFA, IgG <1:40

Interpretive Data: Anti-Nuclear Antibodies (ANA), IgG by ELISA: ANA specimens are screened using enzyme-linked immunosorbent assay (ELISA) methodology. All ELISA results reported as Detected are further tested by indirect fluorescent assay (IFA) using HEp-2 substrate with an IgG-specific conjugate. The ANA ELISA screen is designed to detect antibodies against dsDNA, histone, SS-A (Ro), SS-B (La), Smith, snRNP/Sm, Scl-70, Jo-1, centromere, and an extract of lysed HEp-2 cells. ANA ELISA assays have been reported to have lower sensitivities for antibodies associated with nucleolar and speckled ANA-IFA patterns.
Note: ANA are not specific for systemic lupus erythematosus (SLE) but are found in a variety of rheumatic or connective tissue diseases. When cell culture substrates (HEp-2 cells) are used, the ANA incidence is greater than 90 percent in systemic lupus erythematosus (SLE), 80 percent in Sjogren syndrome and scleroderma, and 40 percent in juvenile idiopathic arthritis.

ARUP uses anti-human IgG conjugate since many (20-77 percent) healthy individuals have low levels (1:40 to 1:80) of ANA-IgM. Conversion of ANAs from IgM to IgG generally precedes the onset of autoimmune disease states. If clinical presentation is inconsistent with the ANA IFA result, consult ARUP for alternative testing.

If ANA are Detected by ELISA, then ANA by IFA titer will be added. Additional charges apply.


If ANA antibodies are detected by ELISA, then an IFA titer will be added. Additional charges apply
CPT Code(s): 86038; if reflexed, add 86039
Cross References: ANA Screen (Anti-Nuclear Antibodies (ANA), IgG by ELISA with Reflex to ANA, IgG by IFA) , Connective Tissue Disease (Anti-Nuclear Antibodies (ANA), IgG by ELISA with Reflex to ANA, IgG by IF , Systemic Lupus Erythematosus (SLE) (Anti-Nuclear Antibodies (ANA), IgG by ELISA with Reflex to ANA