At a Glance
Why Get Tested?
When to Get Tested?
When your healthcare provider thinks that you have symptoms of an autoimmune disorder
A blood sample drawn from a vein in your arm
Test Preparation Needed?
The Test Sample
What is being tested?
Antinuclear antibodies (ANA) are a group of antibodies produced by a person's immune system when it fails to adequately distinguish between "self" and "nonself." These antibodies, known as autoantibodies, attack the body's own healthy cells and cause signs and symptoms such as tissue and organ inflammation, joint and muscle pain, and fatigue. ANA specifically target substances found in the nucleus of a cell, hence the name "antinuclear." The ANA test identifies the presence of these autoantibodies in the blood.
The presence of ANA may be a marker of an autoimmune process and is associated with several autoimmune disorders but is most commonly seen with the autoimmune disorder systemic lupus erythematosus (SLE).
The ANA test is one of the primary tests for helping to diagnose a suspected autoimmune disorder or ruling out other conditions with similar signs and symptoms. As such, it is often followed by other tests for autoantibodies that may help to establish a diagnosis. These may include, for example, an ENA panel, anti-dsDNA, anti-centromere and/or anti-histone test.
How is the sample collected for testing?
A blood sample is taken by needle from a vein in the arm.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
Antinuclear Antibody Panel. (Updated Feb. 3, 2014.) MedlinePlus Medical Encyclopedia. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003535.htm through http://www.nlm.nih.gov. Accessed February 2014.
Von Feldt, J. M. (Updated Feb. 2012.) Antinuclear Antibodies (ANA). American College of Rheumatology. Available online at http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Antinuclear_Antibodies_(ANA)/ through http://www.rheumatology.org. Accessed February 2014.
Abelson, A. et al. Laboratory Evaluation of Rheumatic Diseases. The Cleveland Clinic Foundation. Available online at http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/rheumatology/laboratory-evaluation-rheumatic-diseases/ through http://www.clevelandclinicmeded.com. Accessed February 2014.
Test ID: ANA2 Antinuclear Antibodies (ANA), Serum. Mayo Clinic. Available online at http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/9026 through http://www.mayomedicallaboratories.com. Accessed February 2014.
National Institute of Arthritis and Musculodkeletal and Skin Diseases. Questions and Answers About Arthritis and Rheumatic Diseases. Available online at http://www.niams.nih.gov/Health_Info/Arthritis/arthritis_rheumatic_qa.asp through http://www.niams.nih.gov. Accessed April 2014.
Sources Used in Previous Reviews
The Gale Encyclopedia of Medicine: Antinuclear antibody test. Available online at http://www.findarticles.com/p/articles/mi_g2601 through http://www.findarticles.com.
Kavanaugh A, Tomar R, Reveille J, Solomon DH, Homburger HA. Guidelines for clinical use of the antinuclear antibody test and tests for specific autoantibodies to nuclear antigens. Archives of Pathology and Laboratory Medicine, 2000, 124(1): 71-81.
Steven Lobel, PhD, D-ABMLI, MBA. Laboratory Director, Quest Diagnostics, Baltimore, MD.
H. James Williams, MD. Professor of Medicine, Thomas E. and Rebecca D. Jeremy Presidential Endowed Chair for Arthritis Research, University of Utah School of Medicine, Salt Lake City, UT.
Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 90-92.
Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].
Reeves, W. (2006 July). Fluorescent Antinuclear Antibody (FANA) Test: "False Positive." American College of Rheumatology [On-line information]. Available online at http://www.rheumatology.org/public/factsheets/fana.asp through http://www.rheumatology.org. Accessed on 4/9/07.
Fosam, H. (2006 April 24). The Many Faces of Lupus: An Expert Interview With Stephen Paget, MD. From Medscape Rheumatology, Expert Interview 2006;8(1) [On-line information]. Available online at http://www.medscape.com/viewarticle/529590 through http://www.medscape.com. Accessed on 4/9/07.
Relchlin, M. (2005 February 3, Updated). Laboratory Tests Used in the Diagnosis of Lupus. Lupus Foundation of America [On-line information]. Available online at http://www.lupus.org/education/brochures/labtests.html through http://www.lupus.org.
(2003 August, Revised). Systemic Lupus Erythematosus. National Institute of Arthritis and Musculoskeletal and Skin Diseases, Handout on Health [On-line information]. Available online at http://www.niams.nih.gov/hi/topics/lupus/slehandout/ through http://www.niams.nih.gov. Accessed on 4/15/07.
Bylund DJ, Nakamura RM: Organ-specific autoimmune diseases, in Henry's Clinical Diagnosis and Management by Laboratory Methods, 21st ed. Richard McPherson and Matthew Pincus, eds. Saunders Elsievier: Philadelphia. Pp 945-960, 2007.
Peter JB. Antinuclear antibodies, in Use and Interpretation of Laboratory Tests in Rheumatiology, James B Peter, ed. Speciality Laboratories: Los Angeles. Pp 10-11, 1998.
Smalley DL. Autoimmune diseases, in Clinical Laboratory Utilization and Consultation, BG Davis, D Mass, ML Bishop, eds. WB Saunders: Philadelphia. Pp 467-483, 1999.
Pagana, Kathleen D. & Pagana, Timothy J. (2006). Mosby's Manual of Diagnostic and Laboratory Tests 3rd Edition: Mosby Elsevier, Saint Louis, MO. Pp 91-93.
Burtis C, Ashwood E, Bruns D, eds. (2006). Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, 4th edition, Saunders, Elsevier.
Arbuckle MR et al. Development of autoantibodies before the clinical onset of systemic lupus erythematosus. N Engl J Med 2003 Oct 16; 349:1526-33.
Shmerling RH. Autoantibodies in systemic lupus erythematosus -- there before you know it. N Engl J Med 2003 Oct 16; 349:1499-500.
Borigini, M. (Updated 2009 February 3). Antinuclear antibody panel. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003535.htm. Accessed June 2010.
Von Feldt, J. (Updated 2009 April). Antinuclear Antibodies (ANA). American College of Rheumatology [On-line information]. Available online at http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/ana.asp through http://www.rheumatology.org. Accessed June 2010.
(2009 April). Handout on Health: Systemic Lupus Erythematosus. National Institute of Arthritis and Musculoskeletal and Skin Diseases [On-line information]. Available online at http://www.niams.nih.gov/Health_Info/Lupus/default.asp through http://www.niams.nih.gov. Accessed June 2010.
(Updated 2009 August). Connective Tissue Diseases. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/ConnectiveTissueDz.html# through http://www.arupconsult.com. Accessed June 2010.
Arthur Kavanaugh, MD, Russell Tomar, MD, John Reveille, MD, Daniel H. Solomon, MD, MPH, and Henry A. Homburger, MD. Guidelines for Clinical Use of the Antinuclear Antibody Test and Tests for Specific Autoantibodies to Nuclear Antigens. Arch Pathol Lab Med 124(1):71-81, 2000.
Jacobs DS, DeMott WR, Oxley DK, eds. Laboratory Test Handbook, 5th ed. LexiComp: Cleveland, Pp 507-509, 2001.