Test Overview
Test Methodology

Indirect Fluorescent Antibody (IFA), HEp-2000 substrate

Test Usage

Initial screening test for various autoimmune disease including SLE, rheumatoid arthritis, scleroderma, and mixed connective tissue disease. A titer/pattern will be performed on all positive screens. Any degree of positivity in children suggests possibility of SLE or JRA and the more specific tissue ANA will be run on all children less than 18 years of age.

Reference Range *

Screen: Negative. Titer: <1:80.

Test Limitations

Positive screens are not unusual in elderly or patients with infectious mononucleosis. Various medications can induce a 'lupoid' condition and elevated ANA titers, which usually decrease following removal of the drug. Test sensitivity is 1:80.

Test Details
Days Set Up
Monday - Friday
Analytic Time

Screen: 24 hours; Titer: 48 hours

Soft Order Code
NAB
MiChart Code
ANA by IFA, HEp-2000 Substrate (Rheumatology Patients Only)
Synonyms
  • ANA by IFA
  • FANA
  • HEp-2
  • HEp-2 ANA
  • NAB
  • ANA
  • FANA
  • HEp-2
  • HEp-2 ANA
  • NAB Titer
  • NAB TTR
  • NAB PTTRN
  • NUCLEAR ANTIBODY
  • Nuclear Antibody Titer
  • NAB PATTERN
  • NAB TITER/PATTERN
  • NAB PTTRN
  • NAB TTR
  • NAB PATTERN
  • Nuclear Antibody Titer
Laboratory
Chemical Pathology
Section
Immunopathology
Specimen Requirements
Collection Instructions

Collect specimen in SST tube. Centrifuge, aliquot serum into a plastic vial and refrigerate.

Alternate Specimen
Red top tube.
Rejection Criteria
Fluid and plasma specimens are not acceptable.
Yellow Top Tube
Normal Volume
0.5 mL serum
Minimum Volume
0.2 mL serum
Additional Information

If the screen is positive, a titer will be performed at an additional charge. If the Hep-2000 ANA titer is 1:80 or greater with a homogeneous, speckled, nucleolar, or atypical nuclear matrix pattern in children less than 18 years of age, the more specific tissue ANA will be performed at an additional charge. By ordering this test the clinician acknowledges that additional reflex testing will be performed and billed at a separate additional charge if indicated. The indirect immunofluorescent test has three elements to consider in the result: 1) Positive or negative fluorescence, 2) The titer (dilution) to which fluorescence remains positive, and 3) The pattern of nuclear fluorescence (reflecting specificity for various disease). A negative ANA usually rules out SLE. However, if the ANA is negative and the clinical picture suggests SLE or Sjogren's Syndrome, the physician may wish to order SS-A/RO(See Extractable Nuclear Antibody). The ANA may be positive in other autoimmune disorders and in 5-15% of normal people. It is highly recommended that follow-up testing be performed on positive ANA samples.

Billing
CPT Code
86038
Fee Code
30914
Reflex CPT
86039
Reflex Fee Code
21937
LOINC
42254-3 NAB, 5048-4 NAB TITER