ANA (Antinuclear Antibodies)
A blood test that screens for antinuclear antibodies to help diagnose autoimmune conditions like lupus, rheumatoid arthritis, and Sjögren's syndrome.
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What this test measures
An ANA (antinuclear antibodies) test is a blood test that looks for antinuclear antibodies in your blood. Antibodies are proteins that your immune system makes to fight foreign substances, like viruses and bacteria. But an antinuclear antibody attacks your healthy cells instead. It's called "antinuclear" because it targets the nucleus of the cells, which is in charge of sending signals that are needed for important cell functions.
Antinuclear antibodies are autoantibodies that can bind to components within a cell's nucleus, including DNA and various proteins. It's normal to have a few antinuclear antibodies in your blood. But a large number may be a sign of an autoimmune disorder. Indirect immunofluorescence (IIF) assays using human epithelial type-2 cells (Hep-2 cells), derived from laryngeal carcinoma, are the gold standard to screen for ANAs in systemic autoimmune rheumatic diseases. The test measures both the presence and concentration of these antibodies, typically reported as a titer that indicates how diluted the blood sample can be while still showing detectable antibodies.
Who should consider this test
You might consider this test if you are experiencing any of the following:
- Individuals experiencing unexplained multisystem inflammatory disease, symmetric joint pain with inflammatory features, photosensitive rash, and cytopenias
- Those with suspected autoimmune conditions, particularly when symptoms suggest lupus, Sjögren's syndrome, or scleroderma
- People presenting with specific symptoms such as skin tightening, lupus rashes, inflammatory arthritis, oral or nasal ulcers, alopecia, or cytopenia
- Individuals with a family history of autoimmune diseases who are experiencing suggestive symptoms
- Those being evaluated for connective tissue disorders when other laboratory findings suggest autoimmune disease activity
What to expect
Preparation
No fasting is required for the ANA test. The test can be taken at any time of day. Certain medications may potentially affect results, but individuals should not stop prescribed medications without consulting their healthcare provider first.
Sample Type
A 7 mL blood serum sample is collected in a red top tube through a standard blood draw from a vein, typically in the arm.
Collection
The collection process is quick and straightforward. A healthcare professional will clean the injection site, insert a needle into a vein, and collect the blood sample. The entire process typically takes just a few minutes.
Turnaround
Results are typically available within 1-3 business days. Some laboratories may provide results within 24 hours, while others may take up to one week depending on testing volume and laboratory procedures.
Understanding your results
ANA test results are most often reported in 2 parts: the level or titer and the pattern. Titres are reported in ratios, most often 1:40, 1:80, 1:160, 1:320, and 1:640. The titer indicates how many times the blood was diluted while still showing detectable antibodies. A negative result on an ANA test means that antinuclear antibodies were not found in your blood, and you're less likely to have an autoimmune disorder. A positive result on an ANA test means that antinuclear antibodies were found in your blood. However, interpreting results requires clinical context and additional testing.
| Population | Reference Range | Notes |
|---|---|---|
| Adults (All ages) | Negative: ≤ 1:40; Positive: ≥ 1:80 | The normal ANA level is typically defined as a titer of 1:40 or lower. ANA titers of less than or equal to 1:40 are considered negative. |
Reference ranges shown are general guidelines. Your lab report will include the specific reference range used by the laboratory that processed your sample, which is the authoritative range for interpreting your results.
What does a “Low” result mean?
A negative result on an ANA test means that antinuclear antibodies were not found in your blood, and you're less likely to have an autoimmune disorder. But a negative ANA test doesn't completely rule out the possibility that you could have an autoimmune disorder. Most people with lupus will have a positive ANA test result. It is very rare, but it is possible to have a negative ANA test and still have lupus. A negative result typically indicates a lower likelihood of systemic autoimmune conditions, though some autoimmune diseases may still be present with specific antibodies not detected by the ANA screen.
What does a “High” result mean?
Higher titers, especially those above 1:160, may warrant further investigation, as they can be indicative of autoimmune diseases but do not confirm a diagnosis on their own. The 2019 EULAR/ACR Classification Criteria for SLE now require ANA positivity (≥ 1:80 on HEp-2 or equivalent) as an entry criterion, reflecting its high sensitivity (~97-98%) in SLE diagnosis. Having antinuclear antibodies in your blood doesn't always mean you have a disease. Some healthy people have antinuclear antibodies in their blood, and levels tend to increase with age. Many healthy adults may have a positive ANA test result, especially women over the age of 65. Elevated ANA levels can be associated with various autoimmune conditions including lupus, rheumatoid arthritis, Sjögren's syndrome, and scleroderma, but may also occur in certain infections, cancers, or from specific medications.
Privacy & confidentiality
All test orders are authorized and results reviewed by an independent, board-certified physician who is not the patient's personal doctor. Your ANA test results are completely confidential and handled with the highest level of privacy protection. Results are <u>not sent to your personal doctor</u> unless you specifically request them to be shared, giving you complete control over your medical information. These test results are <u>not added to your medical records</u> automatically and remain separate from your standard healthcare documentation. Your insurance company will not receive these results, and the test <u>will not appear on your insurance explanation of benefits (EOB)</u> since you are paying directly for the test. This privacy-focused approach ensures that you can take charge of your health screening without concerns about unwanted disclosure to employers, insurance companies, or other third parties. The results are accessible only through your secure online portal, providing you with confidential access to your health information whenever you need it.
Frequently asked questions
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CPT Code: 86235
This test may not be available in: NY, NJ, RI
This page is for informational purposes only and does not constitute medical advice. Always consult with a healthcare provider regarding any health concerns. LevelPanel does not diagnose, treat, or prescribe.
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