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all people with these antibodies have lupus. These antibodies include antibodies to the small
RNA-associated proteins Ro/SSA, La/SSB, Sm, U1RNP, Ku, anti-ribosomal P, monocyte
chemotactic protein-1 (MCP-1), vascular cell adhesion molecule (VCAM) intercellular
adhesion molecule (ICAM/CD54), and autoantibodies to RNA helicase A (RHA) among
many [38-44]. Thus, the pathogenic significance and diagnostic value of lupus autoantibodies
in the patients and in their relatives remains under investigation [38-44]. Some physicians
may order a test for anticardiolipin (or antiphospholipid) antibody [45]. The presence of this
antibody may indicate increased risk for blood clotting, as well as increased risk for
miscarriage in pregnant women with lupus [45,46].

Lupus Blood Tests

We shall review five major tests that may be conducted on patient serum.

A. Antinuclear Antibody (ANA)

ANA stands for anti-nuclear antibody. This test detects a group of antibodies directed
against components of the cell nucleus, including DNA and ribonucleoproteins (RNPs)
[36-44]. Individual ANAs include anti-DNA antibodies, and anti-ENA antibodies (see
below). Thus, the composite ANA test is used as a screening test for these autoantibodies,
which may then be identified individually by other tests. The ANA test is positive in 95% of
people with lupus, and only about 5% of healthy people. It can also be positive in people with
related autoimmune conditions (sometimes called connective tissue diseases) such as
dermatomyositis, polymyositis, and systemic sclerosis (scleroderma) [36-44]. It is sometimes
positive in people with other types of diseases, such as chronic infections or selected
malignancies.

B. DNA Antibodies

DNA antibody testing represents the gold standard serum test for lupus. For unknown
reasons, the presence of antibodies against double-stranded DNA represents the hallmark of
the disease. The finding is very specific, and rarely found in any other condition. Strongly
positive anti-DNA antibody tests provide almost total confirmation of the diagnosis. In
addition, the titer of the antibodies provides a rough guide to disease activity; this finding is
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thus utilized by physicians to monitor the clinical course of the disease [36-44].

C. Extractable Nuclear Antigens (ENAs)

The title extractable nuclear antigens applies to a battery of antiantibodies which are
found in lupus variants, as well as in Sjgrens syndrome and mixed connective tissue disease
[47].

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