ANA screen (HEp-2 cells)

Indication

Suspicion of collagenosis diseases, systemic lupus erythematosus, scleroderma, mixed connective tissue disease, primary Sjögren’s syndrome, chronic active hepatitis, hypergammaglobulinemic purpura, juvenile rheumatoid arthritis, drug induced lupus.

Method

Indirect immunofluorescence with human epithelial cells (HEp-2 cells).

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Answer

The result is graded as negative, 1+ (slightly positive), 2+ (positive), 3+ (strongly positive) according to fluorescence intensity and is assessed into different patterns.

Interpretation - Pattern

Homogeneous
ANA with homogeneous pattern is associated to several rheumatic diseases and autoimmune liver disease. Approximately 5% of a healthy population normal serum show weak unspecific patterns.

Samples with homogeneous ANA will be further analyzed for anti-dsDNA, anti-histones and anti-ENA (anti-Sm, anti-nRNP, anti-SSA, anti-SSB, anti-Scl-70, anti-Jo1 and anti-Ro 52).

Speckled
ANA with speckled pattern is associated to several rheumatic diseases and autoimmune liver disease. Approximately 5% of a healthy population normal serum show weak unspecific patterns.

Samples with speckled ANA will be further analyzed for anti-dsDNA and anti-ENA (anti-Sm, anti-nRNP, anti-SSA, anti-SSB, anti-Scl-70, anti-Jo1 and anti-Ro 52).

Nucleolar
ANA with nucleolar pattern is primarily marker of systemic sclerosis of diffuse type, but slightly positive findings can also be seen in other conditions.

Centromere
ANA with centromere pattern is primarily a marker for systemic sclerosis of limited type but are also seen in other rheumatic system diseases and in primary biliary cholangitis (PBC).

Proliferating cell nuclear antigen (PCNA)
ANA with PCNA pattern is an unusual subtype of ANA but is regarded to have high specificity for SLE.

Nuclear dots
In the presence of ANA with nuclear dots pattern, further analysis of antibodies associated with primary biliary cholangitis (PBC) is recommended. Cholestatic liver tests?

Nuclear membrane
In the presence of ANA with nuclear membrane pattern, further analysis of autoantibodies associated with primary biliary cholangitis (PBC) is recommended. Cholestatic liver tests?

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Packages and other tests

View other packages Antiphospholipid syndrome (APS) (510), Autoimmune hepatitis (515), Drug induced lupus (541), Glomerulonephritis (500), Inflammatory Myopathies (Myositis) (551), Scleroderma/systemic sclerosis (523), Sjögren’s syndrome (522), Sudden deafness (530), Systemic lupus erythematosus (SLE) (541)

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