Quick Facts
- Sample: Blood (serum, ~1 mL)
- Fasting: Not required
- Turn-around: 4-5 business days. May take longer based on weather, holiday, or lab delays.
Benefits
- Gold-standard screening using indirect immunofluorescence on HEp-2 cells for superior sensitivity (Mayo Clinic 2025)
- Automatic reflex testing provides titer and pattern details if positive, eliminating need for follow-up orders
- Early detection support for lupus, scleroderma, and other autoimmune conditions before complications arise
- Confidential results reviewed by physicians, delivered securely with clear interpretation guidance
- Convenient direct access – order online, visit local collection site, no physician referral needed
- Clinically validated approach recommended by American College of Rheumatology for autoimmune assessment (ACR 2023)
Who Is This Test For?
- Individuals experiencing unexplained joint pain, swelling, or persistent inflammation
- Those with skin rashes, photosensitivity, or Raynaud's phenomenon symptoms
- People with chronic fatigue, fever, or muscle weakness of unknown origin
- Anyone with family history of lupus, Sjögren's syndrome, or connective tissue disease
- Individuals monitoring known autoimmune conditions or treatment response
- Those prescribed medications that may trigger drug-induced lupus
How It Works – Just 3 Steps
- Order online — Select your test and complete your purchase through our secure platform
- Visit a lab — Get your blood drawn at a convenient local collection site near you
- Receive results — Access your confidential results within 4-5 business days in your online account.
FAQ
What does ANA stand for? ANA stands for antinuclear antibodies—autoantibodies that mistakenly target proteins in your cell nuclei, potentially indicating autoimmune activity.
Can healthy people test positive? Yes, up to 20% of healthy individuals show low-titer positive ANA, especially those over 65 (PubMed Central 2014). Clinical correlation is essential.
What happens if my result is positive? The lab automatically performs reflex testing to measure antibody titer and identify staining pattern, helping guide further evaluation.
How accurate is the IFA method? IFA on HEp-2 cells detects ANA in ~95% of systemic lupus cases, making it highly sensitive (ACR 2023).
Will I need additional tests? Positive ANA results often lead to specific antibody testing like anti-dsDNA or ENA panel for definitive diagnosis.
How long are samples stable? Blood samples remain stable up to 7 days when refrigerated, allowing flexible shipping (Quest Diagnostics 2025).
More Details
What is the purpose of this test?
This test detects antinuclear antibodies in your blood—autoantibodies that mistakenly attack proteins within cell nuclei. ANAs commonly appear in autoimmune diseases like systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome, and mixed connective tissue disease. Unlike protective antibodies that fight infections, ANAs trigger inflammation where your immune system attacks healthy tissue (MedlinePlus 2024).
The test uses indirect immunofluorescence on HEp-2 cells, the gold standard for ANA detection recommended by rheumatology experts. If initial screening is positive, reflex testing automatically measures antibody titer (concentration ratio like 1:160) and identifies nuclear staining patterns (homogeneous, speckled, centromere, nucleolar). These patterns help distinguish specific autoimmune conditions and guide targeted follow-up testing (Mayo Clinic 2025).
Who would benefit from this test?
You may benefit from ANA testing if you experience symptoms suggesting autoimmune disease, including unexplained fever, persistent fatigue, joint pain or swelling, skin rashes (especially those worsening in sunlight), muscle weakness, Raynaud's phenomenon (fingers turning white/blue in cold), swollen glands, or digestive issues. This test also helps monitor disease progression in individuals with diagnosed autoimmune conditions or assess treatment response.
Healthcare providers commonly order ANA screening for suspected systemic lupus erythematosus, Sjögren's syndrome, polymyositis, dermatomyositis, juvenile idiopathic arthritis, drug-induced lupus, autoimmune hepatitis, and mixed connective tissue disease. Family history of autoimmune conditions or taking medications linked to lupus-like syndromes are additional reasons to consider testing (NIAMS 2023).
When should I order an ANA Screen, IFA, with Reflex to Titer and Pattern Blood Test?
Order this test when you notice symptoms consistent with autoimmune disease—particularly combinations like joint pain with rash, fatigue with fever, or Raynaud's phenomenon with muscle aches. Timing matters because early detection enables prompt intervention before complications develop. If you're taking medications potentially causing drug-induced lupus (certain blood pressure medications, antibiotics, or anti-seizure drugs), periodic monitoring helps catch problems early.
Consider testing if you have a family member with lupus or other autoimmune conditions, as genetic factors increase risk. For those already diagnosed with autoimmune disease, your healthcare provider may recommend periodic ANA testing to track disease activity or treatment effectiveness (ACR 2023).
How do I interpret the results?
Negative ANA
- Meaning: No significant antinuclear antibodies detected; autoimmune disease unlikely
- Action: No immediate action; discuss symptoms with provider if they persist
Positive ANA, low titer (1:40–1:80)
- Meaning: Low antibody levels detected; may occur in healthy individuals
- Action: Clinical correlation required; monitor symptoms; consider repeat testing
Positive ANA, moderate titer (1:160–1:320)
- Meaning: Moderate antibody levels; increased likelihood of autoimmune disease
- Action: Evaluate pattern; order specific antibody tests; rheumatology referral
Positive ANA, high titer (≥1:640)
- Meaning: High antibody concentration; strongly suggests active autoimmune process
- Action: Immediate specialist referral; comprehensive autoimmune panel; clinical assessment
ANA positivity occurs in approximately 95% of systemic lupus cases, but up to 20% of healthy adults over 65 may show low-titer positive results without disease (PubMed Central 2014).
Staining patterns provide additional diagnostic clues. Homogeneous patterns often associate with lupus or drug-induced lupus. Speckled patterns appear in various conditions including lupus, Sjögren's syndrome, and mixed connective tissue disease. Centromere patterns suggest limited scleroderma (CREST syndrome). Nucleolar patterns may indicate systemic sclerosis or polymyositis. However, patterns alone cannot definitively diagnose disease—your healthcare provider interprets results alongside your symptoms, physical examination, and other laboratory findings (UNC Medicine).
Important note: positive ANA results don't automatically mean you have autoimmune disease. Viral infections, certain medications, cancer, and other conditions can temporarily elevate ANAs. Context matters—your complete clinical picture determines next steps.
Pre-test preparation
No fasting or special preparation required. You can eat normally and take regular medications before your blood draw. The test requires approximately 1 mL of blood (one standard collection tube) drawn from a vein in your arm. Sample collection takes just minutes at any approved laboratory location.
Blood samples remain stable at room temperature for short periods or refrigerated up to 7 days if shipping is delayed. Laboratory personnel handle all sample processing and testing using standardized protocols.
How often should I get tested?
- Initial symptom evaluation: Once, unless symptoms persist or worsen
- Diagnosed autoimmune disease (stable): Every 6–12 months or as directed by specialist
- Diagnosed autoimmune disease (active flare): Every 3–6 months to monitor treatment response
- Drug-induced lupus risk (chronic medication use): Baseline, then every 6–12 months while on medication
- Family history but no symptoms: Not routinely recommended; test if symptoms develop
Repeat ANA testing frequency depends on your clinical situation. Once-negative results typically don't require retesting unless new symptoms emerge. For diagnosed conditions, your rheumatologist determines optimal monitoring schedules based on disease activity and treatment response. Avoid unnecessary repeat testing, as ANA results generally remain stable unless disease status changes significantly.
Why early detection matters
Early autoimmune disease detection enables timely intervention before irreversible organ damage occurs. Untreated lupus can damage kidneys, heart, lungs, and brain. Systemic sclerosis may cause severe skin thickening and internal organ fibrosis. Early treatment with appropriate immunosuppressive therapy often prevents these complications and improves long-term outcomes.
Prompt diagnosis also reduces the physical and emotional toll of undiagnosed illness. Many people with autoimmune conditions experience years of unexplained symptoms before receiving proper diagnosis. Early detection ends diagnostic uncertainty, enables appropriate specialist care, and improves quality of life through targeted treatment (NIAMS 2023).
Additionally, identifying autoimmune disease early allows lifestyle modifications and preventive strategies. You can avoid known triggers, protect yourself from sun exposure if photosensitive, and make informed decisions about medications or procedures that might worsen your condition.
Related tests you may consider
Anti-dsDNA antibody test – Highly specific for systemic lupus erythematosus; helps confirm lupus diagnosis and monitor disease activity when ANA is positive.
ENA (extractable nuclear antigen) panel – Tests for specific antibodies including anti-Sm, anti-RNP, anti-Ro/SSA, and anti-La/SSB; helps distinguish between different autoimmune conditions when ANA is positive.
Complement C3 – Measures immune system proteins that decrease during active lupus; useful for monitoring disease activity and treatment response.
Complement C4 – Assesses immune proteins that decline with active lupus to help monitor disease activity and therapy progress.
