Antinuclear Antibodies, (ANA Screen)

CPT CODES: 86038 (ENA Screen) & 86225 (Anti-dsDNA)

ORDERING rECOMMENDATION

Useful to detect Antinuclear Antibodies. Suspected Connective Tissue Diseases

specimen required

Specimen Type:

1.0 mL separated serum/plasma

Collection Tube:

Plasma Transport Tube, Request Supplies

Minimum Volume:

1.0mL

Specimen Stability/Storage:

Room Temperature (15-25°C): 7 days Refrigerated (2-8°C): 7 days or Frozen (≤ -20°C): 7 days

Unacceptable Conditions:

Shipping Requirements:

Call 866-983-0667 to schedule courier pickup

Stability:

Refrigerated: 48 hours; Frozen: 30 days

devlab test code
metholodogy
Test NameTest CodeCPT Code
ANA ScreenR1100n/a
Screen Includes:
Anti-dsDNAR1000186225
ENA ScreenR1000186225

Option: ANA Screen w/Full Reflex Cascade

EliA for determination of dsDNA antibodies

performed

Weekly (Monday – Friday)

reported

24-36 hours from receipt (Monday – Friday)

ALTERNATIVE NAMES

ENA Screen and Anti-dsDNA, Connective Tissue Diseases

SUBMIT WITH ORDER

Test Requisition

Results Interpretation

Positive:

Result > 1:80

Equivocal:

Results = 1:80

Negative:

Result < 1:80

Additional Information

Extractable nuclear antibodies (ENAs), also known as antinuclear antibodies (ANAs), are of central
importance to clinical diagnosis of connective tissue diseases (CTDs) and includes antibodies against
double-stranded DNA (dsDNA), Sm, U1RNP (RNP 70, A, C), SS-A/Ro, SS-B/La, Scl-70, Centromere B, and Jo-1. Incidence of specific ENAs varies across different CTDs and testing for these specific ENAs can assist physicians in diagnosing patients with specific connective tissues diseases, such as systemic lupus erythematosus (SLE), lupus nephritis (LN), mixed connective tissue disease (MCTD), Sjögrens syndrome, scleroderma, and polymyositis/dermatomyositis.

The following table describes clinical association of individual ENAs with various connective tissue
diseases 6,7,8:

Antibodies
Detected
Lupus Specificity RatingClinical Associations(s)Other Associated Diseases
Anti-dsDNAHigh sensitivity and
specificity for SLE. Correlates
with disease activity
● SLE: 60 – 98%
● LN: 70%
● NPSLE: 44, 4-80, 6%
RA, HIV, and paravovirus B19 infections, myeloma, and type 1 autoimmune hepatitis.
Anti-SmDLow sensitivity, but high
specificity for SLE
● SLE: 20 – 40%
● LN: 14%
● MCTD: 8%
EBV infection
Anti-U1RNP
(RNP 70, A, C)
High● SLE: 30 – 40%
● MCTD: 100%
Myositis, esophageal hypomotility, sclerodactyly,
Raynaud’s phenomenon, arthralgia and arthritis.
Anti-SS-A/Ro
(60 kDa, 52 kDa)
High prognostic value for
NLE in pregnant women
● SLE: 40%
● LN: 31%
● NLE (especially CHB): 90%
● SCLE: 70 – 80%
● Discoid Lupus: 5 – 20%
Anti-SS-A/Ro and anti-SS-B/La are commonly
identified in patients with Sjögrens syndrome
With photosensitive skin rash, pulmonary disease
and lymhopenia.
Anti-SS-B/LaModerate● SLE: 10 – 15%
● LN: 14%
● Protective for LN
● SCLE: 30%
● NLE: 90%
Late-onset SLE, secondary Sjögrens syndrome and
neonatal lupus syndrome.
Test to confirm the diagnosis of Sjögrens syndrome.
Useful in patients with a positive ANA test and
suspected SLE
Anti-Scl-70Low● Scleroderma: 22 – 40%Diffuse cutaneous disease, pulmonary fibrosis,
cardiac involvement and longer disease duration;
Testing for Scl-70 may be useful in patients with
suspected Scleroderma.
Anti-Centromere-BLow● Scleroderma: 22 – 36%Associated with CREST syndrome and Raynaud’s
phenomenon, limited scleroderma, pulmonary
hypertensions, primary biliary cirrhosis.
Anti-Jo-1Highly specific, but not
sensitive for sclerodeerma
● Polymyositis/
dermatomyositis: 30%
Inflammatory myopathies with interstitial lung
disease, fever, asthma, pulmonary fibrosis and
Raynaud’s phenomenon.

CHB – congenital heart block; LN – lupus nephritis; MCTD – mixed connective tissue disease; NLE – neonatal lupus erythematosus; NPSLE
– neuropsychiatric lupus; SCLE – subacute cutaneous lupus erythematosus; SLE – Systemic lupus erythematosus