December 1, 2015
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Antinuclear Antibody (cont.)

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ANAs are defined as having patterns. What does this mean?

ANAs present different "patterns" depending on the staining of the cell nucleus in the laboratory: homogeneous or diffuse pattern; speckled pattern; nucleolar pattern; and peripheral or rim pattern. 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. These patterns are determined by technical experts who routinely interpret the tests.

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 1:80 or lower 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, underlying medical conditions, and other test results. It may or may not be significant, even if positive, in a given individual.

Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine


"ANA." Lab Tests Online. Feb. 24, 2015. <>.

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.

Medically Reviewed by a Doctor on 5/7/2015


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