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Epic Code LAB3540 IFA ANA (Rheumatology)

Important Note

Ordering Recommendation (Rheumatology):

Preferred confirmatory ANA test for autoimmune connective tissue diseases.

Test Name Alias

ANA | IFA ANA Blood Level | RNAAutoantibodies | ANA Titer: ANA Pattern | 1122 | ANA Hep2 IFA |ANA (Antinuclear Antibodies), Hep2 Substrate IFA with reflex to Titer and Pattern if positive | Anti Nuclear Antibody Hep 2 Substrate with Reflex Titer and Pattern 

Interface Order Alias


Clinical Information

The ANA Hep2 IFA slide is screened at 1:80 dilution. If titer is ≥ 1:80 a titer and pattern will be reported. Patterns reported include Homogeneous, Speckled, Nucleolar, Centromere, and SSA Ro. All positive results are reported with endpoint titers.

ANA (antinuclear antibodies) occur in patients with a variety of autoimmune diseases, both systemic and organ-specific. They are particularly common in systemic rheumatic diseases, which include lupus erythematosus (LE), discoid LE, drug-induced LE, mixed connective tissue disease, Sjogren syndrome, scleroderma (systemic sclerosis), CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) syndrome, polymyositis/dermatomyositis, and rheumatoid arthritis. 

The diagnosis of a systemic rheumatic disease is based primarily on the presence of compatible clinical signs and symptoms. The results of tests for autoantibodies including ANA and specific autoantibodies are ancillary. Additional diagnostic criteria include consistent histopathology or specific radiographic findings.


Some patients without clinical evidence of an autoimmune disease or a systemic rheumatic disease may have a detectable level of antinuclear antibody (ANA). This finding is more common in women than men and the frequency of detectable ANA in healthy women over 40 years of age may approach 15% to 20%. ANA may also be detectable following viral illnesses, in chronic infections, or in patients treated with many different medications.

Collection Instructions

Specimen Collection: Blood

Container(s): Gold Top (Serum Separator-SST Gel)

Preferred Volume to Collect: 5.0 mL

Minimum Volume to Collect: 2.0 mL

Neonate Volume to Collect: 2.0 mL

Capillary collect ok: Yes

Microtainer acceptable: Yes

Collection Instructions:

  • After collection, gently invert tube 8-10 times.
  • Specimen should be processed within 2 hours – See Processing Instructions.

Processing Instructions (Laboratory, Outpatient or Off-site collection)

Processed Specimen: Serum

Centrifuge/Spin: Yes

Aliquot: Yes

Processing Instructions:

  • Allow blood to clot for 30 minutes in a vertical position and centrifuge within 2 hours.
  • Aliquot serum into screw top plastic transport tube.

Transport Temperature: Refrigerated

Rejection Criteria

Specimen not centrifuged within 2 hours

Specimen Stability

Ambient: 8 hours

Refrigerate: 7 days

Frozen: aliquot serum for longer storage (-20°C or below)

Laboratory Retention: 7 days

Reflex Information

Reflex approved by Medical Executive Committee. Please see link: Reflex Testing Document

Test Frequency

Available Monday through Friday, usual TAT 1-3 days.

Reference Range

ANA Hep2 <1:80

Performing Department


Performing Department Laboratory Location

Corewell Health Reference Laboratory, Grand Rapids, MI


ANA Hep2 slide IFA




CDM Code


Epic Test ID



Antinuclear Ab: 9423-5

ANA Titer: 5048-4

ANA Pattern: 13068-2

Mayo Access Code


Reviewed Date