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ANA Screening by IFA

Immunity
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Report in 48Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Antinuclear antibody test screens for autoimmune diseases such as lupus or Sjögren’s syndrome.

₹899₹1,100

18% OFF

ANA Screening by IFA - Comprehensive Medical Guide

  • Why is it done?
    • Test Purpose: The ANA screening detects antinuclear antibodies in the blood, which are autoantibodies that attack the body's own cell nuclei. This test is essential for identifying autoimmune and connective tissue diseases where the immune system mistakenly targets nuclear antigens.
    • Primary Indications: Suspected systemic lupus erythematosus (SLE), Sjögren's syndrome, systemic sclerosis (scleroderma), mixed connective tissue disease (MCTD), polymyositis/dermatomyositis, rheumatoid arthritis evaluation, and other autoimmune conditions
    • Clinical Symptoms Prompting Test: Patients presenting with persistent fatigue, joint pain and swelling, unexplained fever, photosensitive skin rashes, oral ulcers, dry eyes and mouth, Raynaud's phenomenon, or unexplained multi-system symptoms
    • Timing: Performed when autoimmune disease is suspected based on clinical presentation, or as part of initial screening for patients with compatible symptoms. Often ordered before specific antibody panels to determine if further investigation is warranted.
  • Normal Range
    • Reference Values: Negative or <1:40 dilution (normal result)
    • Result Interpretation: Negative = No antinuclear antibodies detected Positive = Antinuclear antibodies present at a specific titer level
    • Titer Levels (when positive): 1:40 (low), 1:80 (low-moderate), 1:160 (moderate), 1:320 (moderate-high), 1:640 (high), ≥1:1280 (very high)
    • Units: Titer ratio (expressed as 1:X dilution factor)
    • Clinical Significance of Normal: Negative ANA makes active systemic autoimmune disease less likely, though does not completely rule it out. Approximately 3-5% of healthy individuals have positive ANA with no disease.
  • Interpretation
    • Negative Result (Negative or <1:40): Indicates absence of detectable antinuclear antibodies. Suggests active systemic autoimmune disease is unlikely, though some diseases may have negative ANA early in disease course or in seronegative variants.
    • Low Positive (1:40-1:80): May be seen in healthy individuals, viral infections, certain medications, or early-stage autoimmune disease. Requires clinical correlation; borderline significance without compatible symptoms.
    • Moderate Positive (1:160-1:320): More suggestive of autoimmune disease, especially when combined with clinical symptoms. Warrants further investigation with specific antibody panels and clinical assessment.
    • High Positive (≥1:640): Strongly suggestive of systemic autoimmune disease. Particularly supportive of SLE diagnosis. Should prompt immediate follow-up with specific autoantibody testing and clinical correlation.
    • Fluorescence Pattern Significance: Homogeneous pattern (common in SLE), speckled pattern (MCTD, anti-Ro/SSA), nucleolar pattern (systemic sclerosis), centromere pattern (limited scleroderma). Pattern helps guide specific antibody testing.
    • Factors Affecting Results: Medications (procainamide, hydralazine, isoniazid), viral infections, malignancy, smoking, age (higher prevalence in older adults), female gender, genetic predisposition, and concurrent diseases.
    • Clinical Significance: ANA is screening test with high sensitivity but moderate specificity. Positive result requires clinical correlation and specific antibody testing for diagnosis confirmation. Serial titers not routinely recommended for disease monitoring.
  • Associated Organs
    • Primary Organ Systems Involved: Immune system (autoimmune dysfunction), kidneys, joints, skin, lungs, heart, nervous system, and blood vessels. Autoimmune disease affects multiple organ systems simultaneously.
    • Associated Diseases - Systemic Lupus Erythematosus (SLE): Positive ANA in 95-98% of SLE patients; often with homogeneous pattern and high titers. Affects joints, skin, kidneys, heart, lungs, nervous system. Can cause glomerulonephritis, pericarditis, and central nervous system involvement.
    • Associated Diseases - Sjögren's Syndrome: Positive ANA in 40-60% of cases; primarily affects salivary and lacrimal glands causing dry mouth and dry eyes. May involve lungs, kidneys, and nerves.
    • Associated Diseases - Systemic Sclerosis (Scleroderma): Positive ANA in 70-95% of patients; typically nucleolar or centromere patterns. Affects skin, lungs, heart, kidneys, and gastrointestinal tract. Associated with pulmonary fibrosis and renal crisis.
    • Associated Diseases - Mixed Connective Tissue Disease (MCTD): Positive ANA with speckled pattern; combines features of SLE, scleroderma, and polymyositis. Affects joints, skin, lungs, and heart.
    • Associated Diseases - Polymyositis/Dermatomyositis: Positive ANA in 50-80% of cases; primarily affects skeletal muscles and skin. Dermatomyositis includes characteristic skin findings. May involve lungs and heart.
    • Other Associated Conditions: Drug-induced lupus, rheumatoid arthritis (30-50%), autoimmune hepatitis, autoimmune thyroiditis, primary biliary cirrhosis, vasculitis syndromes. Also seen in viral infections, malignancy, and certain medications.
    • Potential Complications from Underlying Disease: Lupus nephritis (progressive kidney damage), cardiovascular complications (myocarditis, pericarditis), pulmonary hypertension, interstitial lung disease, stroke or transient ischemic attacks, thromboembolism, and infection risk from immunosuppressive therapy.
  • Follow-up Tests
    • If Positive ANA - Specific Autoantibody Panel: Anti-dsDNA (double-stranded DNA antibodies - highly specific for SLE), Anti-Smith (Sm) antibodies (highly specific for SLE), Anti-Ro/SSA and Anti-La/SSB (Sjögren's syndrome and SLE subset), Anti-RNP (mixed connective tissue disease), Anti-Scl-70 (systemic sclerosis), Anticentromere antibodies (limited scleroderma)
    • Inflammatory Markers: Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and complement levels (C3, C4) to assess disease activity and help confirm autoimmune disease
    • Complete Blood Count (CBC): To evaluate for cytopenias (anemia, leukopenia, thrombocytopenia) commonly seen in SLE and other connective tissue diseases
    • Comprehensive Metabolic Panel (CMP): To assess kidney function (creatinine, BUN), liver function, and electrolytes; baseline important before immunosuppressive therapy
    • Urinalysis: To screen for proteinuria and active urinary sediment indicative of lupus nephritis
    • Coagulation Studies: PT/INR, PTT, and if indicated, anticardiolipin and lupus anticoagulant testing for thrombosis risk assessment
    • Imaging Studies: Chest X-ray (evaluate for pleuritis, infiltrates, pulmonary hypertension), and based on clinical presentation: echocardiogram (pericarditis, valvular disease), CT chest (interstitial lung disease), or joint imaging (arthritis)
    • Additional Serological Tests: Rheumatoid factor (RF), anti-CCP antibodies (anti-cyclic citrullinated peptide) for rheumatoid arthritis, tissue-specific antibodies (anti-thyroid, anti-mitochondrial), and antineutrophil cytoplasmic antibodies (ANCA)
    • Monitoring Frequency for Positive Diagnoses: Once diagnosis established, repeat ANA titers are generally NOT recommended for disease monitoring. Instead, monitor with specific antibodies (anti-dsDNA), complement levels, and clinical parameters. Follow-up depends on disease activity and treatment response (typically every 3-6 months).
    • Complementary Testing Rationale: ANA alone is insufficient for diagnosis; specific antibodies provide diagnostic specificity, organ involvement screening (kidney, heart, lungs) is essential to guide treatment decisions and assess prognosis
  • Fasting Required?
    • Fasting Requirement: NO - Fasting is NOT required for ANA screening by IFA
    • Blood Draw Timing: Can be performed at any time of day, regardless of food intake. Patient may eat and drink normally before the test.
    • Medications - No Discontinuation Required: Continue all regular medications including autoimmune-related treatments, immunosuppressants, and other medications. No medications need to be stopped before this test.
    • Note on Drug-Induced Results: Certain medications (procainamide, hydralazine, isoniazid, minocycline, TNF-alpha inhibitors) can induce positive ANA; inform provider of current medications for result interpretation
    • Sample Collection Requirements: Standard venipuncture for serum blood sample; typically 5-7 mL of blood collected in serum separator tube (SST)
    • General Patient Preparation: Inform healthcare provider of recent infections, medications, supplements, and any autoimmune symptoms. Wear comfortable, loose-fitting sleeves for easier venipuncture access.
    • Best Practice Timing: While test can be performed anytime, optimal timing may be when symptoms are active (higher antibody levels more likely). Test performed during disease remission or on immunosuppressive therapy may have false-negative results.

How our test process works!

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