Antinuclear Antibody (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What are antinuclear antibodies?
- How is the ANA test designed? What is it for?
- What are autoimmune diseases?
- What other conditions cause ANAs to be produced?
- Can medications cause ANAs to be produced?
- ANAs are defined as having patterns. What does this mean?
- Are ANAs always associated with illness?
ANAs are defined in certain patterns. What does this mean?
ANAs present different "patterns" depending on the staining of the cell nucleus in the laboratory: homogeneous or diffuse; speckled; nucleolar; and peripheral or rim. While these patterns are not specific for any one illness, certain illnesses can more frequently be associated with one pattern or another. The patterns then can sometimes give the doctor further clues as to types of illnesses to look for in evaluating a patient. For example, the nucleolar pattern is more commonly seen in the disease scleroderma. The speckled pattern is seen in many conditions and in people who do not have any autoimmune disease.
Are ANAs always associated with illness?
No. ANAs can be found in approximately 5% of the normal population, usually in low titers (low levels). These people usually have no disease. Titers of lower than 1:80 are less likely to be significant. (ANA titers of less than or equal to 1:40 are considered negative.) Even higher titers are often insignificant in patients over 60 years of age. Ultimately, the ANA result must be interpreted in the specific context of an individual patient's symptoms and other test results. It may or may not be significant in a given individual.
REFERENCES: Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.
Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.
Shiel, WC, et al. The Diagnostic Associations of Patients With Antinuclear Antibodies Referred to a Community Rheumatologist, J Rheumatology 1989;16:782-5.
Last Editorial Review: 1/26/2011
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