Ulta Lab Tests

ANA Screen,IFA, Reflex Titer/Pattern,and Reflex to Multiplex 11 Ab Cascade

Blood
Blood Draw
There are no preparation instructions.

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Also known as: ANA IFA WRefl To TiterPatternCascade

ANA Screen, IFA

The antinuclear antibody (ANA) test is ordered to help screen for autoimmune disorders and is most often used as one of the tests to diagnose systemic lupus erythematosus (SLE).
*Important Information on Lab Test Processing Times: Ulta Lab Tests is committed to informing you about the processing times for your lab tests processed through a national lab. Please note that the estimated processing time for each test, indicated in business days, is based on data from the past 30 days across the 13 laboratories for each test. These estimates are intended to serve as a guide and are not guarantees. Factors such as laboratory workload, weather conditions, holidays, and the need for additional testing or maintenance can influence actual processing times. We aim to offer estimates to help you plan accordingly. Please understand that these times may vary, and processing times are not guaranteed. Thank you for choosing Ulta Lab Tests for your laboratory needs.

The ANA Screen,IFA, Reflex Titer/Pattern,and Reflex to Multiplex 11 Ab Cascade test contains 1 test with 1 biomarker .

Includes

  • The ANA Screen,IFA, Reflex Titer/Pattern,and Reflex to Multiplex 11 Ab Cascade begins with an ANA Screen, IFA.
  •  
  • If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).
  • Additionally, five antibodies will be performed at an additional charge: dsDNA (CPT code(s): 86225), Sm/RNP (CPT code(s): 86235), RNP (CPT code(s): 86235), Sm (CPT code(s): 86235), and Chromatin (CPT code(s): 86235).
  • If any of those five antibodies are positive, the cascade stops and the results are reported.
  • If all five of those antibodies are negative, four additional antibodies will be performed at an additional charge: SSA (CPT code(s): 86235), SSB (CPT code(s): 86235), Scl-70 (CPT code(s): 86235), Jo-1 (CPT code(s): 86235).
  • If any of those four antibodies are positive, the cascade stops and the results are reported.
  • If all four of those antibodies are negative, the following two additional antibodies will be performed at an additional charge: Ribosomal P (CPT code(s): 83516) and Centromere B (CPT code(s): 86235).
  •  
  • Please note the cascade stops upon the first positive antibody result(s) found in a group and an interpretive message is applied based on this information. It is possible that antibodies in subsequent groups are also positive, but will not be added, billed, or reported. Please contact your local Quest Diagnostics Laboratory if you are interested in adding this additional testing.

Methodology

Immunofluorescence Assay (IFA)

Reference Range(s)

 

ANA Screen Negative
  ANA Titer  
  <1:40 Negative
  1:40-1:80 Low antibody level
  >1:80 Elevated antibody level

 

Alternative Name(s)

Calcinosis,Esophageal dysmotility,Systemic Lupus Erythematosus (SLE),Mixed Connective Tissue Disease,MCTD,FANA,Antinuclear Antibody Screen,Fluorescent ANA,Hep-2,Progressive ANA,Raynaud's phenomena,Sclerodactyly,Telangiectasia,Multiplex Cascade,Dermatomyositis,CREST

 

Clinical Significance

ANA Screen,IFA, Reflex Titer/Pattern,and Reflex to Multiplex 11 Ab Cascade - 

This test can be helpful in the diagnosis of autoimmune rheumatic diseases. Specimens with positive results for antinuclear antibodies (ANAs) on the immunofluorescence assay (IFA), performed on human epithelial type 2 (HEp-2) cells, are subsequently tested for a series of disease-specific autoantibodies in cascade tiers. The first tier focuses on autoantibodies associated with systemic lupus erythematosus (SLE) and mixed connective tissue disease; the second tier detects autoantibodies seen in Sjogren Syndrome, progressive systemic sclerosis, and polymyositis; and the third tier includes markers of the limited form of systemic sclerosis and neuropsychiatric SLE. 

ANA IFA on HEp-2 cells is considered by the American College of Rheumatology as the current gold standard for ANA screening because of its overall high sensitivity for several autoimmune diseases [1]. Knowing the titer and fluorescent staining pattern can be helpful in interpreting positive results. Because ANAs can be present in many other diseases as well as in individuals without autoimmune disease, testing for specific autoantibodies may offer greater specificity and help support the diagnosis.

Individuals with negative results on the ANA IFA usually also have negative results on most of the clinically important specific autoantibodies. Therefore, additional testing by immunoassay is not recommended for individuals without positive ANA IFA results and clinical suspicion of relevant autoimmune disease. However, Jo-1 antibody may be detected in ANA IFA-negative patients with some types of myositis, and SSA antibody may be detected in some ANA IFA-negative patients with lupus or Sjogren syndrome [2].

Note that the cascade stops with the first tier in which a positive antibody result is observed. Therefore, even if an antibody included in a subsequent tier is present, it will not be reported with this test. If the ANA IFA result is positive but all the specific autoantibodies tested in the cascade are negative, the patient may still have an autoimmune disease other than those typically associated with the antibodies tested.

The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.

Customer Reviews