Description

Results are reported as qualitative (negative/positive) along with the final dilution/titer, intensity & pattern ofstaining and antigen specificity with disease association. Titer is reciprocal of last serial dilution with clearlydiscernible pattern of staining. A cut-off dilution of 1:80 with intensity of = +2 is generally considered significant for most ANA by IIF method although relevant reference range with cut-off dilution & intensity or titer may vary withtype of ANA. Titers of 1:40 to 1:80 are considered low titers that are frequently insignificant clinically. Medium (1:160 to 1:320)and high (1:640 and greater) titers are generally significant. Positive ANA result is identified by specific clinicallysignificant IF pattern, associated with a distinct autoantibody & to a particular disease thereof & must beconfirmed by a specific test (e.g. Immunoblot, ELISA, ID or CIE with other tests).Medium/High titer ANAs arestrongly suggestive of systemic rheumatic disease and need confirmation by other specific test & clinicalcorrelation for diagnosis.Low titer ANA (False Positive) may be observed in conditions other than systemicrheumatic disease like elderly female population, pregnancy, malignancies, viral illness, chronic inflammation,other autoimmune disorders, drugs etc and in apparently healthy normal individuals. The prevalence of ANAs inhealthy individuals is about 3-15% and increases to 10-37% in those over the age of 65 (strongly age-dependent)with female gender. Transient ANAs are associated with viral infections and some medications. Diseases likemalignancies can cause a positive ANA. The ANAs in such cases present as low titer (<1:160) or low intensity(+/++). Although positive titers of 1:160 or higher are strongly associated with autoimmune disorders, they are alsofound in 5% of healthy individuals. In general, about 11-13% of persons with a positive ANA test have lupus.
randomly selected population were to be screened with ANA testing, 50 or more healthy people with a positiveANA would be identified for every one patient with systemic lupus erythematosus (SLE). Recent observation ofdistinguishing characteristics of the ANA pattern in healthy persons and patients with autoimmune diseaseindicates that the identification of ANA pattern may help discriminating these individuals. Healthy people in thisstudy showed mostly nuclear fine speckling and did not present nuclear coarse speckled or homogeneous pattern,whereas those with autoimmune disease exhibited nuclear coarse speckled, centromere, homogenous and finespeckled (in high titer) patterns. The study also revealed after a follow up for 04 years that, 73% of theANA-positive healthy individuals retained a positive test result and did not develop any symptoms of autoimmunerheumatic disease.ANA by IIF is very sensitive and has false negative results < 02%. False negative may be due to steroid therapy(masking effect), presence of more than one antibody or prozone phenomenon due to very high tittered antibody.Technical reasons related to light source, optics & filters of the fluorescent microscope also influence thesensitivity.CAUTIONS Confirmation of positive ANA results with other appropriate test may show discordant results due to variablesensitivity of the methods (e.g. IIF Vs WB or ELISA), type and titer of the antibody, other technical issues andclinical course of the disease & treatment offered. Careful interpretation and repeat testing may be of help. Titre isgiven using only 1:80 dilution. It is approximately decided accordingly Kit Insert
The antinuclear IMMUNOFLUORESCENCE panel is a blood test that appears at antinuclear antibodies (ANA).
Antinuclear antibodies are substances produced by the immune system that attack the bodys own tissues.
Alternative Names
ANA; ANA panel
How the test is performed
Blood is drawn from a vein, sometimes from the within of the elbow or the rear of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care supplier wraps associate degree band round the higher arm to use pressure to the realm and build the vein swell with blood.
Next, the health care supplier gently inserts a needle into the vein. The blood collects into associate degree airtight phial or tube hooked up to the needle. The elastic band is removed from your arm.
Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.
In infants or young youngsters, a pointy tool referred to as a lancet could also be wont to puncture the skin and build it bleed. The blood collects into alittle glass tube referred to as a measuring system, or onto a slide or check strip. A bandage could also be placed over the realm if there’s any haemorrhage.
How to prepare for the test
No special preparation is needed. However, certain drugs, including birth control pills, procainamind, and thiazide diurectics, affect the accuracy of this test. Make sure your doctor is aware of regarding all the medicines you’re taking.
How the test will feel
When the needle is inserted to draw blood, some individuals feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
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Why the test is performed
Your doctor might order this check if you have got signs of associate degree autoimmune disease, particularly systemic lupus erythematosus. This check could also be done if you have got unexplained symptoms like inflammatory disease, rashes, or chest pain.
Normal Values
Usually, there’s no detectable ANA within the blood (negative test). Sometimes, however, folks that don’t have any specific malady might have low levels of ANA for no obvious reason.
ANA is reportable as a “titer.” Low titers are in the range of 1:40 to 1:60. A positive ANA is far additional vital if you furthermore mght have antibodies against the double-stranded kind of desoxyribonucleic acid.
ANA does not confirm a diagnosis of systemic lupus erythematosis (SLE). However, a scarcity of ANA makes that identification abundant less seemingly.
Although the ANA is most frequently known with disseminated lupus erythematosus, a positive ANA can also be a sign of other autoimmune diseases.
Normal price ranges might vary slightly among completely different laboratories. Talk to your doctor regarding the which means of your specific check results.
The examples on top of show the common measurements for results for these tests. Some laboratories use {different|totally completely different|completely different} measurements or might check different specimens.
What abnormal results mean
The presence of ANA within the blood could also be due to:
Chronic liver disease
Collagen vascular disease
Drug-induced lupus erythematosus
Myositis (inflammatory muscle disease)
Rheumatoid arthritis
Sjogren syndrome
Systemic lupus erythematosus
Increased ANA levels may sometimes be seen in people with:
Systemic sclerosis (scleroderma)
Thyroid disease
What the risks are
Veins and arteries vary in size from one patient to a different and from one facet of the body to the opposite. Obtaining blood from some individuals could also be harder than from others.
Other risks related to having blood drawn square measure slight, but may include:
Excessive bleeding
Fainting or feeling light-headed
Hematoma (blood accumulating under the skin)
Infection (a slight risk any time the skin is broken)
Special considerations
The ANA can be positive in relatives of people with SLE who do not have SLE themselves.
A positive ANA continuously desires any analysis, including a careful history, physical exam, and blood tests for other antibodies, especially anti-double-strand DNA antibodies.
If the sole finding may be a low concentration of ANA and everything else is negative, there’s solely a five-hitter probability of that patient developing general lupus erythematosis at some time later in life.