Antinuclear Antibody Test – (ANA)

What is an Antinuclear Antibody Test?

The ANA test is used to detect the presence of antinuclear antibodies (ANA) in blood. In case the presence of the same is detected, it can be used to determine whether you have an autoimmune disorder. The test is generally accompanied by a physical examination and a detailed study of the symptoms.

The white blood cells generate antibodies that fight off the invading elements in the body. In some exceptional cases, these antibodies make the mistake of treating the body’s own cells as foreign. These are called autoantibodies and they make the immune system attack your own body creating the autoimmune diseases.

How do these antibodies affect us?

The ANA targets the nuclear material of a cell, specifically those released from that of a dying or an injured tissue. The normal cells generally remain out of their reach as the nuclei are not accessible. The ANAs can cause damage to the joints, skin, muscles and many other parts of your body. Most of us have some minor percentage of ANA in our blood but having too much of it can be a sign of an autoimmune disease.

In many cases, infections, cancers, liver diseases and some other forms of problems can also result in a higher count of ANA. A positive test for ANA cannot diagnose any particular disease and it is generally used in association with other tests.

What diseases are associated with high ANA count?

This group of antibodies is responsible for various conditions which include systemic lupus erythematosus, Sjogren’s syndrome, systemic sclerosis, inflammatory myositis, mixed connective tissue disorder, and rheumatoid arthritis.

Not everybody who has higher levels of ANA will be having an autoimmune disease. Individuals with multiple infections and those consuming certain medications can have elevated levels of ANA. The ANA levels also have a tendency to increase with age and almost one-third of healthy adults, especially women, over the age of 65 have elevated levels. Only in a few specific cases, can give rise to a cascading effect causing various forms of inflammation and resulting in a serious condition.

Why do I need to undergo an Antinuclear Antibody test?

The test is ordered when the doctor suspects the presence of a systemic autoimmune disorder. The symptoms of such a disorder have a wide range and they generally fluctuate between periods of flare-ups and remissions. These are the few symptoms that are noted before the test is ordered.

– Low-grade persistent fever
– Persistent fatigue and weakness
– Arthritis-like pain in one or more joints accompanied by muscle pain. The pain can be more during the morning hours.
– Red rash (for lupus, a special kind of rash resembling a butterfly appears across the nose and cheeks)
– Skin sensitivity to light
– Hair loss
– Numbness or tingling in the hands or feet
– Inflammation and damage to organs and tissues, including the kidneys, lungs, heart, lining of the heart and blood vessels.

In many cases, the doctors can also suspect an autoimmune disorder, particularly systemic lupus erythematosus, and order the test. Since the test is indicative and cannot point out a specific disease, the doctor may need to order further specific tests to determine the exact cause of the symptoms. Specific tests linked with signs of inflammation, active lupus, active autoimmune disease, and kidney problems are also conducted.

How is an Antinuclear Antibody test performed?

The ANA test is like any other normal blood test which needs a sample of your blood. The process is conducted through the method of venipuncture and it is carried out through the following steps.

– An elastic band is tied in the upper arm to make the veins swell with blood, thus making it easy for the technician to mark the right spot.

– The collection site is generally around the elbow region and the area where the needle is inserted is disinfected.

– A needle is inserted into the vein and the required volume of blood is drawn through it in an attached tube. You will feel a sting or some pain when the needle is inserted and it leaves a small mark on the skin.

– The needle is withdrawn and you will be asked to apply pressure on the site through a gauze or a cotton role to prevent any excess bleeding. The spot is then covered with a sterile bandage and the sample is sent to the laboratory for testing.

– In the case of infants and children, the skin is punctured by a scalpel and the blood is collected in a tube for necessary testing. For some individuals locating a suitable vein might be difficult and multiple punctures may be needed.

– In some cases, the test can result in excessive bleeding or the formation of a hematoma, which is blood building up under the skin. Infections at the puncture site are rare but can occur in some cases.

– There are multiple methods that are used for conducting the test. Some of these methods are indirect immunofluorescence, immunodiffusion,counter-immunoelectrophoresis, and enzyme-linked immunosorbent assay.

What is the price of the antinuclear antibody test in India? 

The cost of the test generally ranges from Rs 300 to Rs 800 depending on the location and the facilities involved.

When will I get the test results?

The report is generally delivered with 24 hours. Some laboratories may take longer.

What is the normal range for an Antinuclear Antibody test?

A positive ANA test is usually reported as a ratio, termed titer, and sometimes as a pattern, such as smooth or speckled. A titer ratio indicates the dilution of the blood with saline water and a ratio of 1:80 means that one part of blood is mixed with 80 parts of saline. If the presence of ANA is detected at a ratio of 1:640 or greater, the probability of an autoimmune disease is higher.

Certain laboratories use a reference number and use an arbitrary unit of measurement to indicate a result that is above the reference figure, as positive. A negative result indicates that no ANA is present in the blood.

What do the results indicate?

A positive test result might be indicative of any of these conditions.

– Around 50 to 70 % of patients with Sjögren’s syndrome have positive test results. The doctor can order tests like anti- SSA and anti-SSB antibodies for the confirmation of this condition.

– Systemic lupus erythematosus (lupus) can affect different parts of your body, including the heart, kidneys, joints, and skin.

– Rheumatoid arthritis can affect and demobilize the joints and can also affect organs like lungs, heart and the eyes.

– An autoimmune disorder called scleroderma that primarily affects the skin and other connective tissues.

– Conditions like polymyositis or dermatomyositis which cause muscle inflammation and pain, along with rashes.

– Ailments related to the thyroid gland like hypothyroidism and hyperthyroidism.

– Polyarteritisnodosa is a rare autoimmune disease that causes the blood vessels to swell up and damage the organs.

The doctor will have to order additional tests to confirm the presence of a particular autoimmune disease. If the symptoms persist and the test results appear negative, further tests will be conducted for a better diagnosis. The following conditions can also result in a positive test result.

– Raynaud’s syndrome
– Thyroid diseases like Hashimoto’s thyroiditis and Grave’s disease
– Liver diseases like autoimmune hepatitis, primary biliary cirrhosis
– Inflammatory bowel disease
– Some lung diseases.

Do I need to fast for the Antinuclear Antibody test?

Fasting is not necessary before undergoing the test.

What else do I need to know before I appear for an Antinuclear Antibody test?

The following points will help you to get a clearer idea about the test.

– The test does not need any preparations but you should inform the doctor about any medicines that you might be consuming. Some medicines can impact the test results and you might be advised to stop the intake for some period.

– A large section of healthy adults will test positive for antinuclear antibodies even if they do not have any autoimmune disease. This can be due to multiple factors mentioned earlier.

– Since the ANA test cannot confirm the exact disease that you have, other tests will be needed. Make sure that you clearly understand the results and the details about how the other test results will affect your treatment by discussing it with your doctor.

– If the reports lead to the diagnosis of a specific autoimmune disease, keep in mind that such diseases can be treated effectively.

Can pregnant women undergo an antinuclear Antibody test?

A pregnant woman can undergo the test as it is simple and free from risks.

Is the Antinuclear Antibody test possible for new-born babies?

The test is possible for new-born babies as directed by the doctor.