Useful diagnostic and prognostic information can be gained in ANA positive patients by knowing the specificity of the autoantibodies that are detected. Ideally, collagen vascular disease diagnosis is based on a combination of clinical symptoms and laboratory testing. It is not cost effective to follow up every positive ANA with assays for all 10 possible detectable antibody specificities. MLabs promotes a more cost effective strategy an ENA 5 Antibody Panel (includes SS-A, SS-B, Sm, RNP, and SmRNP) (order code ENA5). These antibodies will account for the vast majority of significant positive results. Other ENA antigens such as Scl-70, Centromere B, Jo-1, and Ribosomal P should not be routinely screened for, but ordered as individual tests as the differential diagnosis dictates. The laboratory recommends either anti-dsDNA (order code ADNA) or crithidia DNAIFA (order code DNAIF) to detect and quantify anti-dsDNA.