Antinuclear Antibodies (ANA) Comprehensive Profile

Antinuclear Antibodies (ANA) Comprehensive Profile

CPT Test code: 86225;86235

Test Includes: Anticentromere B antibodies; anti-dsDNA; antichromatin antibodies; anti-Jo-1; RNP antibodies; antiscleroderma 70 antibodies; Smith antibodies; Sjögren anti-SS-A; Sjögren anti-SS-B
Specimen: Serum
Volume: 1 mL
Minimum Volume: 0.5 mL (Note: This volume does not allow for repeat testing.)
Container: Red-top tube or gel-barrier tube
Special Instructions: Test is intended to be used as a follow-up to Antinuclear Antibodies (ANA) Direct [164855].
Storage Instructions: Maintain specimen at room temperature.
Causes for Rejection: Hemolysis; lipemia; gross bacterial contamination; icterus
Use: Detect antibodies associated with SLE and mixed connective tissue disease. Anti-Sm is highly specific for SLE. Anti-RNP is found with a variety of rheumatoid diseases. RNP, Sm, SS-A, SS-B, Scl-70, and Jo-1 are extractable nucleoprotein complexes found in the nucleus and/or cytoplasm of substrate cells.
References: Astion ML, Wener MH, Hutchinson K, “Autoantibody Testing: The Use of Immunofluorescence and Other Assays,” Clin Lab News, 2000, (7):30-4.

Berner ES, Webster GD, Shugerman AA, et al, “Performance of Four Computer-Based Diagnostic Systems,” N Engl J Med, 1994, 330(25):1792-6.PubMed 8190157

Centers for Disease Control and Prevention, “Manual Guide − Safety Management N°CDC-22 Decontamination of Laboratory Sink Drains to Remove Azide Salts,” Atlanta, GA: CDC, April 30, 1976.

Eriksson C, Engstrand S, Sundqvist K-G, “Autoantibody Formation in Patients With Rheumatoid Arthritis Treated With Anti-TNF Alpha,” Ann Rheum Dis, 2005, 64(3):403-7.PubMed 15297281

Fulton RJ, McDade RL, Smith PL, “Advanced Multiplexed Analysis With the FlowMetrix System,” Clin Chem, 1997, 43(9):1749-56.PubMed 9299971

Golightly M, Golightly C, “Laboratory Diagnosis of Autoimmune Diseases,” MLO Med Lab Obs, 2002, 34(7):12-16, 20.PubMed 12134551

Homburger HA, Cahen YD, Griffiths J, “Detection of Antinuclear Antibodies: Comparative Evaluation of Enzyme Immunoassay and Indirect Immunofluorescence Methods,” Arch Pathol Lab Med, 1998, 122(11):993-9.PubMed 9822128

Isenberg DA, “Systemic Lupus Erythematosus and Sjögren’s Syndrome: Historical Perspective and Ongoing Concerns,” Arthritis Rheum, 2004, 50(3):681-3.PubMed 15022304

Kallenberg CG, Wouda AA, Hoet MH, “Development of Connective Tissue Disease in Patients Presenting With Raynaud’s Phenomenon: A Six Year Follow-up With Emphasis on the Predictive Value of Antinuclear Antibodies as Detected by Immunoblotting,” Ann Rheum Dis, 1988, 47(8):634-41.PubMed 3261966

Kavanaugh A, Tomar R, Reveille J, “Guidelines for Clinical Use of the Antinuclear Antibody Test and Tests for Specific Autoantibodies to Nuclear Antigens. American College of Pathologists,” Arch Pathol Lab Med, 2000, 124(1):71-81.PubMed 10629135

Narain S, Richards HB, Satoh M, et al, “Diagnostic Accuracy for Lupus and Other Systemic Autoimmune Diseases in the Primary Care Setting,” Arch Intern Med, 2004, 164(22):2435-41. PubMed 15596633

Phan TG, Wong RC, Adelstein S, “Autoantibodies to Extractable Nuclear Antigens: Making Detection and Interpretation More Meaningful,” Clin Diagn Lab Immunol, 2002, 9:(1):1-7.PubMed 11777822

Reeves WH, Satoh M, “Autoantibodies in Systemic Lupus Erythematosus,” Arthritis and Allied Conditions: A Textbook of Rheumatology, 14th ed, Koopman WJ, ed, Philadelphia, Pa: Lippincott, Williams and Wilkins, 2001, 1483.

Reichlin M, Harley JB, “Antinuclear Antibodies: An Overview,” Dubois Lupus Erythematosus, 5th ed, Wallace DJ, Hahn BH, eds, Baltimore, MD: Williams and Wilkins, 1997, 403.

Reisner BS, DiBlasi J, Goel N, “Comparison of an Enzyme Immunoassay to an Indirect Fluorescent Immunoassay for the Detection of Antinuclear Antibodies,” Am J Clin Pathol, 1999, 111(4):503-6.PubMed 10191770

Rekvig OP, Kalaaji M, Nossent H, “Anti-DNA Antibody Subpopulations and Lupus Nephritis,” Autoimmun Rev, 2004, 3(2):1-6.PubMed 15003181

Simón JA, Cabiedes J, Ortiz E, “Antinucleosome Antibodies in Patients With Systemic Lupus Erythematosus of Recent Onset. Potential Utility as a Diagnostic Tool and Disease Activity Marker,” Rheumatology (Oxford), 2004, 43(2):220-4.PubMed 13130152

Sturgess A, Edmonds J, “Improving the Effectiveness of Autoantibody Testing in the Clinic,” Autoimmun Rev, 2002, 1(5):273-8.PubMed 12848980

Tan EM, “Autoantibodies in Diagnosis and in Identifying Antigens,” Immunologist, 1999, 7(3):85-92.

Tan EM, Smolen JS, McDougal JS, et al, “A Critical Evaluation of Enzyme Immunoassays for Detection of Antinuclear Autoantibodies of Defined Specificities. I. Precision, Sensitivity, and Specificity,” Arthritis Rheum, 1999, 42(3):455-64.PubMed 10088768

Tozzoli R, Bizzaro N, Tonutti E, et al, “Guidelines for the Laboratory Use of Autoantibody Tests in the Diagnosis and Monitoring of Autoimmune Rheumatic Diseases,” Am J Clin Pathol, 2002, 117(2):316-34.PubMed 11863229

Zlatkis A, Lee KY, Poole CF, “Capillary Column Gas Chromatographic Profile Analysis of Volatile Compounds in Sera of Normal and Virus-Infected Patients,” J Chromatogr, 1979, 163(2):125-33.PubMed 541363