Antinuclear Antibody Test (ANA Test) (2022)

Overview

What is an ANA test?

An antinuclear antibody (ANA) test looks for antinuclear antibodies in your child’s blood. If your child tests positive for ANAs, it may mean they have an autoimmune disease. An autoimmune disease causes your child’s immune system to attack their own cells, tissues and organs by mistake.

What are antinuclear antibodies?

Antibodies are proteins made by white blood cells in your child’s immune system. Antibodies help defend against invaders (such as viruses and bacteria) that cause disease or infection.

Sometimes antibodies mistakenly attack your child’s own cells. These antibodies are called autoantibodies. An antinuclear antibody is an autoantibody that targets the center (nucleus) of a cell. The nucleus contains DNA, which tells the cell what to do. If there are enough antinuclear antibodies present, your child’s immune system may start to attack its own body.

Large amounts of ANAs in your child’s blood may be a sign of an autoimmune disease. But not everyone with elevated ANA levels has an autoimmune disease. Up to 30% of healthy people have detectable levels of ANAs. They’re also present in people with viral infections and in people using certain medications.

(Video) Antinuclear Antibodies (ANA) test and their patterns | ANA test | What does ANA test positive mean?

What is an ANA test used for?

ANAs can be present in various situations. Your child’s healthcare provider doesn’t use an ANA test to diagnose an autoimmune disorder. But they can use the results of an ANA test to help determine what kind of disease your child may have. Autoimmune diseases that can cause a positive ANA result include:

  • Systemic lupus erythematosus (SLE): SLE (lupus) is an inflammatory disease. It causes joint pain, fever, weakness, fatigue, skin rashes and organ damage.
  • Scleroderma: Scleroderma is a rare disease that causes abnormal thickening and hardening of your child’s skin and tissues. It can also affect your child’s gastrointestinal tract, lungs, kidneys, heart, blood vessels, muscles and joints.
  • Polymyositis: Polymyositis is a disease of your child’s muscles that causes inflammation and weakness. It usually affects the muscles closest to your child’s trunk.
  • Dermatomyositis: Dermatomyositis occurs when people have disease features of polymyositis and also skin involvement such as a scaly rash, swelling and purple spots.
  • Mixed connective tissue disease (MCTD): MCTD shares features with SLE, scleroderma and polymyositis. Usually, the symptoms of these diseases don’t occur at the same time. Rather, they occur one after the other over a long period of time.
  • Juvenile onset idiopathic arthritis (JIA): JIA is a type of arthritis that may affect the joints in a variety of ways in your child’s body. Their hands, wrists, knees and other joints may be affected. It may also affect other parts of your child’s body, including their skin, eyes, lungs, heart and blood.
  • Sjögren’s syndrome: Sjögren’s syndrome is a condition that reduces the amount of moisture produced by the glands in your child’s eyes and mouth. Your child’s immune system damages the tear system in their eyes and the salivary glands in their mouth.

If your child has lupus and is taking an immunosuppressant, their healthcare provider may order frequent laboratory tests to track the effectiveness of the medication. But they typically won’t repeat or use the ANA as a marker of disease activity.

Why would my child need an ANA test?

Your child’s healthcare provider may order an ANA test if your child has symptoms of an autoimmune disease. Symptoms of autoimmune disorders may include:

  • Fever.
  • Butterfly-shaped red rash.
  • Extreme tiredness (fatigue).
  • Joint stiffness and swelling.
  • Muscle pain.

Test Details

How does an ANA test work?

An ANA test measures the level of antinuclear antibodies in a blood serum sample. The most widely used method is called indirect immunofluorescence assay (IFA). Another name for this method is fluorescent antinuclear antibody (FANA) test.

(Video) ANA test positive means ? | ANA test procedure (antinuclear antibody test)

With an ANA screen with IFA, a pathologist will add your child’s serum sample to a microscope slide. They’ll add an antibody containing a fluorescent dye to the sample. The fluorescent antibody attaches to the cells in the sample. When a pathologist views the slide under a special microscope, any present ANAs will appear as fluorescent cells.

How does my child prepare for an ANA test?

Your child doesn’t need to do anything special to prepare for an ANA test. They can eat and drink normally on the day of the test. Some medications can cause positive ANA test results, so you’ll want to discuss any medications your child is taking with their provider. Your child’s healthcare provider can also answer any questions you or your child have.

What should my child expect during an ANA test?

An ANA test is a blood test. Your child’s healthcare provider will collect a small amount of blood in their office or a laboratory. Your child’s healthcare provider will look for a good vein to use on your child’s arm. Once they find a usable vein, they may tie an elastic band around your child’s upper arm or ask your child to make a fist. They’ll clean the site and then insert a small needle into the vein.

Your child’s healthcare provider will draw a small amount of blood into a test tube or vial. When the tube is full, they’ll remove the elastic band from around your child’s arm and withdraw the needle from their arm. Your child may feel a slight sting as the needle goes in or out. They may also feel a slight throbbing at the site where the blood was drawn.

What should my child expect after an ANA test?

After the ANA test, your child’s healthcare provider may use gauze or a cotton ball to apply slight pressure to the site where the blood was drawn. This helps reduce bleeding, swelling and bruising. They’ll apply a clean, dry bandage to the site. The entire process usually takes less than five minutes. Then, your child’s healthcare provider will send the sample to a laboratory for testing.

(Video) Testing anti-nuclear antibodies (ANA) – Francisca Hodge and Hazel Hinds

What are the risks and side effects of an ANA test?

There’s very little risk to having a blood test. Your child may experience minor discomfort or bruising at the site where the blood was drawn. But any pain or bruising should quickly subside.

Results and Follow-Up

When should I know the results of my child’s ANA test?

The length of time it takes to receive ANA test results can vary. They may be available within a few days. If your child’s healthcare provider orders other tests, they may share the results with you after reviewing all of them.

What do the results of an ANA test mean?

An ANA test report will show three factors: interpretation, titer reading and fluorescent pattern.

Interpretation

A negative interpretation means your child’s blood had no detectable levels of ANAs. An autoimmune disorder is less likely. A positive interpretation means your child’s blood had detectable levels of ANAs. An autoimmune disorder is possible, but more tests are necessary to confirm.

(Video) Antinuclear Antibody Testing

Titer reading

Titer reading measures the amount of antibodies in your child’s blood. A pathologist will add salt water (saline) to the protein-rich liquid part of your child’s blood (plasma). This method is like making lemonade from a can of frozen concentrate. You dilute one can of concentrate into four cans of water. For a titer reading, they’ll mix one part plasma into 40 parts saline to create a 1:40 dilution. The mixture is called a titer.

They’ll take the mixture through a series of additional steps of dilution. They’ll create a new sample at half the strength (1:80). They’ll continue this process until the test yields a negative result. The pathologist will report the last dilution that yields a positive result.

Fluorescent pattern

If ANAs are present, the pathologist will see fluorescent cells making a staining pattern. The fluorescent pattern seen can help identify the type of autoimmune disease present. Staining patterns include:

  • Homogenous: A homogenous staining pattern means the entire nucleus is stained with ANA. It’s the most common type of staining pattern. A homogenous pattern can mean any autoimmune disease but more specifically, lupus or Sjögren’s syndrome.
  • Speckled: A speckled staining pattern means fine, coarse speckles of ANA are present throughout the nucleus. A speckled pattern may indicate various diseases, including lupus and Sjögren’s syndrome.
  • Centromere: A centromere staining pattern means the ANA staining is present along the chromosomes. A centromere pattern may indicate scleroderma.
  • Nucleolar: A nucleolar staining pattern means ANA staining is present around the nucleoles. The nucleoles is inside the nucleus and produces the cell’s ribosomes. A nucleolar pattern may indicate scleroderma. But it can also indicate Sjögren’s syndrome or mixed connective tissue disease or be a false positive.
  • Peripheral: A peripheral staining pattern means ANA staining is present around the edges of the nucleus. It has a shaggy appearance. A peripheral pattern may indicate lupus.

What does a positive ANA result mean?

A positive ANA screen result means antinuclear antibodies are in your child’s blood. This may mean your child has an autoimmune disease, such as lupus. But elevated ANA in your child’s blood doesn’t mean your child has an autoimmune disorder. Many healthy people have ANAs in their blood. Also, certain medications and viral infections can affect the results of an ANA test.

If your child’s ANA test is positive, their provider will usually order further tests before making a diagnosis. ANA test results can’t interpret an autoimmune disorder on its own. To diagnose or rule out an autoimmune disorder, your child’s healthcare provider will consider your child’s:

(Video) 1. Different Methods to Detect ANA (antinuclear antibodies)

  • ANA test results.
  • Symptoms.
  • Physical examination.
  • Other lab tests.

What questions should I ask my child’s healthcare provider?

  • How should my child prepare for an ANA test?
  • Will my child have other tests at the same time as the ANA test?
  • How does my child’s ANA test result help me understand the cause of their symptoms?
  • Does my child need any follow-up tests based on their test result?

A note from Cleveland Clinic

If your child needs an ANA test, you may both be worried. The test itself is a simple blood draw that should take less than five minutes. The results of an ANA test are just one factor your child’s healthcare provider will look at when diagnosing an autoimmune disease. They’ll also look at your child’s symptoms, family history and other test results before making a diagnosis. However, the results of an ANA test can help provide valuable clues to help figure out if your child has an autoimmune disease.

FAQs

What is a normal ANA level? ›

Normal Results

Titres are reported in ratios, most often 1:40, 1:80, 1:160, 1:320, and 1:640. Some, but not all labs will report a titre above 1:160 as positive. Patterns that are reported include, homogeneous, speckled, centromere, and others.

Is a positive ANA test serious? ›

Results. The presence of antinuclear antibodies is a positive test result. But having a positive result doesn't mean you have a disease. Many people with no disease have positive ANA tests — particularly women older than 65.

Is ANA positive life threatening? ›

The finding of antinuclear antibody (ANA) positivity in a healthy individual is usually of unknown significance and in most cases is benign. However, a subset of such individuals is at risk for development of autoimmune disease.

What causes high ANA test? ›

Causes of a false-positive ANA include infection, malignancy, and certain medications. Therefore, a positive ANA test does not equal a diagnosis of lupus or any autoimmune or connective tissue disease.

Can stress cause positive ANA? ›

In contrast, among ANA screening patient sera, with no diagnosis of CTD, the fraction showing stress-positive ANA was higher (7 to 8%, depending on the type of stress) than among those showing a lower reactivity with stress antigen (1.5 to 2.5%).

How do I read my ANA profile results? ›

A positive interpretation indicates that autoantibodies were detected in a patient's blood sample. A positive result on an ANA test does not always indicate that a patient has an autoimmune disorder. Many healthy patients test positive for ANAs.
...
Staining patterns include:
  1. Homogenous.
  2. Speckled.
  3. Centromere.
  4. Nucleolar.
9 Nov 2021

What are the 7 autoimmune diseases? ›

Common autoimmune disorders include:
  • Addison disease.
  • Celiac disease - sprue (gluten-sensitive enteropathy)
  • Dermatomyositis.
  • Graves disease.
  • Hashimoto thyroiditis.
  • Multiple sclerosis.
  • Myasthenia gravis.
  • Pernicious anemia.
24 Apr 2021

Does positive ANA mean lupus? ›

If your doctor says your ANA test is “positive,” that means you have antinuclear antibodies in your blood — but it doesn't necessarily mean you have lupus. In fact, a large portion of patients with a positive ANA do not have lupus.

Can thyroid cause a positive ANA? ›

Abstract. Both positive antinuclear antibody (ANA) and anti-DNA antibodies have been reported in patients with autoimmune thyroid disease.

Can allergies cause a positive ANA test? ›

The presence of selected antibodies in some allergic disorders suggests their autoimmune origin [50, 51]. Recent scientific evidence confirms the presence of antinuclear antibodies (ANA) in patients with allergic diseases [51].

What is the cost of ANA test? ›

An ANA test helps determine the level of ANA in your blood. ANA test cost varies from Rs 500 to Rs 1500.

Can you have a positive ANA and not have an autoimmune disease? ›

Even when detected at high titer, a positive ANA result, by itself (in the absence of symptoms or physical findings), does not indicate that a patient either has, or will develop, an autoimmune disease. Some ANA appear to be unrelated to the development of autoimmune disorders.

Is ANA positive in all autoimmune diseases? ›

By itself, a positive ANA does not in any way mean you have an autoimmune disease or need treatment. It simply means that there are autoantibodies present.

What is the next step after a positive ANA test? ›

For patients with a positive ANA, more tests are usually performed to check for other antibodies that can help confirm the diagnosis. This series of tests, commonly called an ANA panel, checks for the following antibodies: anti-double-stranded DNA, anti-Smith, anti-U1RNP, anti-Ro/SSA, and anti-La/SSB.

Does fibromyalgia cause positive ANA? ›

False-positive ANA tests are particularly likely to occur in the elderly. Most of the false-positive ANAs were of low titer, but even a high-titer ANA is not proof of an underlying connective tissue disease. Therefore, not surprisingly, ANA testing is frequently positive in patients with fibromyalgia.

Can stress cause positive ANA? ›

In contrast, among ANA screening patient sera, with no diagnosis of CTD, the fraction showing stress-positive ANA was higher (7 to 8%, depending on the type of stress) than among those showing a lower reactivity with stress antigen (1.5 to 2.5%).

Can inflammation cause positive ANA? ›

Autoantibodies to cartilage proteoglycan can be measured in several systemic and joint-specific rheumatic diseases including Sjogren's Syndrome, rheumatoid arthritis, lupus and ankylosing spondylitis [21], suggesting that undetected or preclinical joint inflammation may contribute to ANA positivity.

Can ANA positive be reversed? ›

The new criteria require that the test for antinuclear antibody (ANA) must be positive, at least once, but not necessarily at the time of the diagnosis decision because an ANA can become negative with treatment or remission.

What causes positive ANA results? ›

A positive result on an ANA test means that antinuclear antibodies were found in your blood. A positive result may be a sign of: Systemic lupus erythematosus (SLE) A different type of autoimmune disease.

What causes high ANA test? ›

A positive ANA test means autoantibodies are present. By itself, a positive ANA test does not indicate the presence of an autoimmune disease or the need for therapy. Some medications cause a positive ANA. Tell your doctor all prescription, over the counter, street drugs and supplements you take.

Can ANA levels decrease? ›

ANA titers may increase and decrease over the course of the disease; these fluctuations do not necessarily correlate with disease activity.

What is the treatment for ANA? ›

If the ANA test confirms a diagnosis of lupus, drug treatments may include pain relievers called nonsteroidal anti-inflammatory drugs. Examples of these include ibuprofen and naproxen. Other medications that can help manage lupus symptoms include : hydroxychloroquine or chloroquine, for reducing inflammation.

What are the 7 autoimmune diseases? ›

Common autoimmune disorders include:
  • Addison disease.
  • Celiac disease - sprue (gluten-sensitive enteropathy)
  • Dermatomyositis.
  • Graves disease.
  • Hashimoto thyroiditis.
  • Multiple sclerosis.
  • Myasthenia gravis.
  • Pernicious anemia.
24 Apr 2021

Does positive ANA mean lupus? ›

If your doctor says your ANA test is “positive,” that means you have antinuclear antibodies in your blood — but it doesn't necessarily mean you have lupus. In fact, a large portion of patients with a positive ANA do not have lupus.

Can a positive ANA make you tired? ›

Fatigue is a common feature of the anti-nuclear antibody (ANA)-positive systemic autoimmune rheumatic diseases (SARDs), including systemic lupus erythematosus (SLE), Sjogren's disease (SjD), systemic sclerosis (SSc), dermatomyositis, and mixed connective tissue disease [1,2,3,4,5].

What were your first signs of lupus? ›

Symptoms
  • Fatigue.
  • Fever.
  • Joint pain, stiffness and swelling.
  • Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body.
  • Skin lesions that appear or worsen with sun exposure.
  • Fingers and toes that turn white or blue when exposed to cold or during stressful periods.
27 Jan 2021

What does early lupus feel like? ›

Painful, swollen joints

Inflammation can cause pain, stiffness, and visible swelling in your joints, particularly in the morning. It may be mild at first and gradually become more obvious. Like other symptoms of lupus, joint problems can come and go.

Videos

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