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The Anti-Nuclear Antibodies (ANA) test by Immunofluorescence (IF) detects antibodies that target components of the cell nucleus...
Also known as: ANA Test · FANA Test · Antinuclear Antibody Test · Immunofluorescence ANA · Fluorescent ANA
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*Inclusive of home collection charges
The Anti-Nuclear Antibodies (ANA) test by Immunofluorescence (IF) detects antibodies that target components of the cell nucleus — produced in autoimmune conditions where the immune system mistakenly attacks the body's own nuclear material. A positive ANA is the hallmark finding in Systemic Lupus Erythematosus (SLE) and is also seen in a wide range of other autoimmune conditions. The immunofluorescence method is the gold-standard ANA assay — it is highly sensitive, provides a titre (indicating antibody quantity), and characterises the fluorescence pattern (which suggests specific autoimmune diagnoses). No fasting required.
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What Does the Anti-Nuclear Antibodies (ANA) Test — Immunofluorescence Measure?
| Level / Result | Possible Interpretation |
|---|---|
| Negative (< 1:40) | No significant ANA — SLE and most ANA-associated autoimmune diseases are very unlikely with a negative ANA |
| Weak positive (1:40–1:80) | Low-titre ANA — present in 5–15% of healthy individuals, especially elderly women; clinical correlation essential; repeat if symptoms evolve |
| Positive (≥ 1:160) — Homogeneous pattern | Associated with SLE (anti-dsDNA, anti-histone) — order anti-dsDNA and anti-Sm for SLE confirmation |
| Positive (≥ 1:160) — Speckled pattern | Associated with Sjogren's (anti-Ro/SSA, anti-La/SSB), MCTD (anti-U1RNP), SLE — order specific extractable nuclear antigen (ENA) panel |
| Positive (≥ 1:160) — Centromere pattern | Associated with limited scleroderma / CREST syndrome — anti-centromere antibody (ACA) positive |
| Positive (≥ 1:160) — Nucleolar pattern | Associated with diffuse scleroderma (anti-Scl-70 / anti-topoisomerase I) and overlap syndromes |
| High titre (≥ 1:640) with symptoms | Highly significant — specialist rheumatology evaluation and full autoimmune antibody panel required urgently |
Important Note: A positive ANA is not a diagnosis — it is a screening finding that directs further specific testing. Approximately 5–15% of the healthy population (particularly elderly women) have weak positive ANA without autoimmune disease. ANA positivity must be interpreted alongside clinical features (symptoms, examination findings, organ involvement) and specific autoantibody testing. A negative ANA essentially excludes SLE. All ANA-positive results must be reviewed by a rheumatologist.
ANA Patterns and Their Clinical Associations — The Pattern Guides the Next Test: The fluorescence pattern seen on HEp-2 cell immunofluorescence provides the first diagnostic clue: Homogeneous (diffuse nuclear staining) → Anti-dsDNA and anti-histone → SLE. Speckled (discrete nuclear dots) → Anti-Ro/SSA, anti-La/SSB → Sjogren's; Anti-U1RNP → MCTD; Anti-Sm → SLE. Centromere (discrete chromosome dots) → Anti-centromere antibody → CREST syndrome/limited scleroderma. Nucleolar (nucleolar staining) → Anti-Scl-70, anti-PM-Scl → Diffuse scleroderma, overlap syndromes. Cytoplasmic patterns → Anti-Jo-1 → Polymyositis/dermatomyositis. Reading the pattern turns a positive ANA from a generic 'something is wrong' into a specific diagnostic pointer.
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Screens for anaemia, infections, and immune health
