Antinuclear Antibody Test (ANA)

DEFINITION

--The antinuclear antibody (ANA) test is a test done early in the

evaluation of a person for autoimmune or rheumatic disease,
particularly Systemic Lupus Erythematosus.

--Fluorescence techniques are frequently used to actually detect the

antibodies in the cells, thus ANA testing is sometimes referred to as
fluorescent antinuclear antibody test (FANA). The ANA test is a
sensitive screening test used to detect autoimmune diseases.

INDICATION
--In Autoimmune Diseases, the body makes antibodies that work
against its own cells or tissues. Rheumatic diseases are also associated
with these antibodies.

This test is particularly useful when diagnosing a person with

symptoms of SLE, an illness that affects many body organs and
tissues. If the test is negative, it is unlikely that the person has SLE; if
the test is positive, more tests are done to confirm whether the person
has SLE or another related disease.

PREPARATION
No special preparations or diet changes are required before a person
undergoes an ANA test.

PROCEDURE

Five to 10 mL of blood is needed for this test. The antinuclear antibody

test is done by adding a person's serum to commercial cells mounted
on a microscope slide. If antinuclear antibodies are in the serum, they
bind to the nuclei of cells on the slide. Next, a second antibody is
added to the mixture. This antibody is "tagged" with a fluorescent dye
so that it can be seen. The second antibody attaches to any antibodies
and cells bound together and, because of the fluorescent "tag," the
areas with antinuclear antibodies seem to glow, or fluoresce, when the
slide is viewed under an ultraviolet microscope.
If fluorescent cells are seen, the test is positive. When positive, the
serum is diluted, or titered, and the test done again. These steps are
repeated until the serum is so dilute it no longer gives a positive result.
The last dilution that shows fluorescence is the titer reported.
The pattern of fluorescence within the cells gives the physician clues
as to what the disease might be. The test result includes the titer and
the pattern.
Results are available within one to three days.

Normal results
Normal results will be negative, showing no antinuclear antibodies.

Abnormal results
A positive test in a person with symptoms of an autoimmune or
rheumatic disease helps the physician make a diagnosis. More than
95% of people with SLE have a positive ANA test. SCLERODERMA has a
60-71% positive rate; Jorgen’s disease, 50-60%, and RHEUMATOID
ARTHRITIS 25-30%.

NURSING RESPONSIBILTY
Discomfort or bruising may occur at the puncture site or the person
may feel dizzy or faint. Pressure to the puncture site until the bleeding
stops reduces bruising. Warm packs relieve discomfort.

KEY TERMS

Antibody—A special CHON built by the immune system as a defense

against foreign material entering the body.

Autoantibody—an antibody that attacks the body's own cells or

tissues.

Antinuclear antibodies—Auto antibodies that attack substances

found in the center, or nucleus, of all cells.

Autoimmune disease—Disease in which the body makes antibodies

against its own cells or tissues.

Titer—A dilution of a substance with an exact known amount of fluid.

For example, one part of serum diluted with four parts of saline is a
titer of 1:4.
 Antinuclear
Antibody
Test (ANA)
PHARMACOLOGY

SIR ELMO MAAGAD

Ellesse Gem S. Aulmo

BSN2A1