ANA Test: Purpose, Price, Procedure & Results [2024]
ANA Test or Antinuclear Antibody Test is a blood test that detects anti-nuclear antibodies, a type of autoantibody, in your blood. These antibodies specifically target the cell’s nucleus (thus called anti-nuclear) and cause cell damage. While the immune system usually creates antibodies to fight against foreign substances, it can sometimes mistake the body’s own cells for harmful substances. Such antibodies are known as autoantibodies. ANA test price varies from Rs 500 to Rs 1500. The actual cost depends on the city, lab, and locality.
Anti-nuclear antibodies react with components of the body’s own healthy cells. It can cause tissue and organ inflammation, joint and muscle pain, and fatigue. While it’s normal to have some ANA, having too many of these proteins is a sign of active autoimmune disease.
ANA Test Details in Brief
| Also Known As | Antinuclear antibody panel, fluorescent antinuclear antibody, FANA, ANA, ANA reflexive panel, Antinuclear Factor (ANF) |
| Purpose | To help diagnose autoimmune disorders, such as Systemic Lupus Erythematosus, Scleroderma, RA, etc |
| Preparation | Overnight fasting is preferred. |
| Reporting Time | <24 Hrs. |
| Cost | Rs. 500 to Rs. 1500 |
ANA Test Price
The ANA Test Price usually ranges from Rs 500 to Rs 1500. The actual price depends on the diagnostic centre and the city. Bookmerilab partners with more than 200 diagnostic centres across India. We provide a 10-50% discount on medical diagnostic tests.
Price at Popular Diagnostic Centres
The table below lists the ANA prices at a few popular diagnostic centres in India.
| Name of Lab | Test Price |
|---|---|
| Redcliffe Lab | Rs 1400 |
| Thyrocare | Rs 520 |
| Metropolis Healthcare | Rs 950 ( City-based ) |
| SRL Diagnostics | Rs 1000 |
| Dr Lal Path labs | Rs 700 |
| Vijaya Diagnostics | Rs 1800 |
Cost in different cities
The table below lists the prices in different cities. You can click on the name of the city to get the list of diagnostic centres with their price and discount.
| City | Test Price |
|---|---|
| ANA Test Price in Delhi | Rs 550 to Rs 2100 |
| ANA Test Price in Mumbai | Rs 550 to Rs 950 |
| ANA Test Price in Bangalore | Rs 550 to Rs 1000 |
| ANA Test Price in Hyderabad | Rs 550 to Rs 1100 |
| ANA Test Price in Gurgaon | Rs 550 to Rs 2100 |
| ANA Test Price in Chennai | Rs 550 to Rs 950 |
| ANA Test Price in Kolkata | Rs 450 to Rs 550 |
ANA Test Purpose
An ANA test looks for antinuclear antibodies in your blood. If the test finds antinuclear antibodies in your blood, it may mean you have an autoimmune disorder. Thus, this test helps detect and diagnose certain autoimmune disorders such as
- Systemic Lupus Erythematosus (SLE)– the most common type of lupus which is can affect the skin, joints, kidneys, lungs, heart, brain and blood cells
- Sjogren’s syndrome– causes dry eyes and dry mouth as it affects the glands that produce saliva and tears
- Rheumatoid arthritis– a chronic inflammatory disorder that affects the joints including those in the hands and feet
- Scleroderma– a connective tissue disorder affecting the skin, causing joint pain, heartburn and an exaggerated response to cold.
- Addison’s Disease, due to lower cortisol production by adrenal glands, causes fatigue and weakness.
- Autoimmune hepatitis causes inflammation in your liver.
Symptoms: When To Get The ANA Test?
You should get an ANA test in case you are experiencing the following symptoms.
- fever
- joint pain
- fatigue
- swelling
- muscle pain
- red butterfly-shaped rashes
It is always better to consult a doctor before ordering the test.
Types of ANA tests
There are different types of ANA tests depending on the testing method and the number of parameters included. Your Doctor should prescribe you one depending on your clinical indication.
ANA Profile Test
It includes 17 parameters like Ds DNA, Nucleosome, histone SmD1 (Anti Smith antibodies), PCNA (Proliferating Cell Nuclear antigen), PO (Rib-PO), SS-A/ Anti Ro(60 kD), SS-A/ Anti Ro (52 kD), SS-B (Anti LA), CENP-B (Centromere Pattern-B), SCL-70 (Sclerostin 70), U1-snRNP, AMA-M2, Anti JO-1 antibody, PM Scl (Polymyositis/Scleroderma), Mi-2, and Ku.
ANA Blot Test
It includes a combination of selected parts of up to 22 specific antigens of Jo-1, PmScl, SS-A/Ro 52, SS-A/Ro 60, SS-B/La, Scl-70, RNP-A, RNP-C, RNP-68, SmB, SmD, centromere B, centromere A, PL-7, PL-12, ribosomal protein P0, PCNA, histones, dsDNA, M2, DFS70, and nucleosome. Then, recombinant antigens are applied to the nitrocellulose membrane (i.e. to the respective BLOT‑LINE (BL) strips). If specific antibodies are present in the sample, they will bind to the respective antigens.
ANA ELISA Test
ELISA is a testing method, and sometimes a Doctor may specify a specific method for testing.
Preparation
Do inform your doctor if you are taking any medicine, both prescription and non-prescription, ayurvedic, etc. Your doctor may advise you to stop the ones that can affect the test results, like antihypertensives ( drugs used for high BP). DO NOT stop any medication on your own.
During an ANA test, Overnight fasting is preferred.
What is the ANA test Procedure?
It is a fairly simple diagnostic blood test. A blood sample is taken from the vein in your arm or hand by the following steps-
- A technician (phlebotomist) may tie a tourniquet (elastic band) to your arm.
- The phlebotomist will locate your blood vessel.
- Then the site is cleaned with spirit.
- A Needle is inserted into your vein to draw the blood.
- The blood sample is then withdrawn into a syringe or a vial.
- Cotton is placed on the puncture site with mild pressure till the bleeding stops.
- A small band-aid is then placed, which may be removed after an hour.
The entire procedure takes only a few minutes.
Risks
It is a very simple and safe test. The risks involved are the same as that of any other blood test. These include-
- Infection at the puncture site if proper sterilization protocol is not followed and the needle is contaminated. This is, however, very rare. You may ensure that your phlebotomist takes out the needle in front of you from a sterile pack.
- Multiple pricks if the blood vessel is not easily found
- Excessive bleeding at the puncture site- Please inform your healthcare provider if you are taking any blood thinners or have any bleeding disorders.
- Light-headedness due to stress or heavy bleeding.
Minor pain and bruising that might occur will resolve on their own in a very short time.
ANA Test Results and Interpretation
Test results are available within 24-48 hours of sample collection. For urgent cases, early results can be requested.
Normal (Negative) Results
If your Anti-nuclear antibody level is below 20 Units by the ELISA method, then it is a negative result. Another testing method is IFA or immunofluorescence technique, which measures the result in titer. It is discussed in detail in a further section.
A negative ANA result means you are at low risk of an autoimmune disease. It usually is not necessary to immediately repeat a negative ANA test. However, due to the episodic nature of autoimmune diseases, it may be worthwhile to repeat the test at a future date if symptoms recur.
| Parameter | Normal value/ Threshold | Unit |
|---|---|---|
| Anti-nuclear antibody | 20 | Units/U |
Positive Results
A positive result of the ANA test means that antinuclear antibodies are present above the threshold level in your blood. In most cases, a positive ANA test indicates that your immune system has launched a misdirected attack on your own tissue. A positive result is likely if you have –
- Lupus, the most common type being SLE (Systemic Lupus Erythematosus)
- Other autoimmune diseases like scleroderma, Rheumatoid arthritis
- Viral infection
- Cancer
- Thyroid disease
- Liver disease
A positive result doesn’t necessarily mean you have a disease. There are cases wherein healthy people do have antinuclear antibodies in their blood. In addition, certain medicines can affect your results. Also, antinuclear antibody levels tend to increase with age.
How To Interpret Results
The ELISA Technique involves the interaction of antibodies, primarily IgG, present in the serum sample with a prepared antigen and the addition of an antibody that binds to this complex and induces a colour change. The result is an optical density value (a photometric scale) that is read as positive, or negative. Hence ELISA is more of a qualitative test. Newer ELISA tests have been developed with increased sensitivity and specificity. They are comparatively easier to conduct but more costly as compared to the IF technique.
The immunofluorescence (IF) technique is currently considered as the gold standard in ANA testing. It uses HEp-2 substrate with an IgG-specific conjugate to help determine the presence of antibodies in the serum sample. Immunofluorescence patterns are observed under a microscope in a positive (+) test result. ANA is reported as a “titer”. The samples are screened after being diluted 1:40 to 1:160 in a buffered solution. If staining is observed at both dilutions, then more dilution is done until no more staining is visible under the microscope. The level to which a patient’s sample can be diluted with recognizable staining is known as ANA titer. Higher titers mean more antibodies are present.
The interpretation at some titer levels is given below for reference-
| ANA titer | Interpretation |
|---|---|
| 1:30 | No Antibodies found |
| 1:320 | Antibodies are found |
| 1:1300 | Antibodies are very high |
Immunofluorescence patterns are disease-specific like-
- Homogenous: SLE, drug-induced lupus
- Speckled: SLE, Sjogren syndrome, Scleroderma
- Nucleolar: Scleroderma, Polymyositis
- Centromere: CREST syndrome
Some people who are absolutely fit might have a low level of ANA which is considered absolutely safe. The presence of a low level of ANA is not always abnormal.
ANA Test Sample Report
Limitations
A negative ANA test does not necessarily rule out an autoimmune disorder. Similarly, many individuals with a positive result may never develop any autoimmune disorder. If the test results are positive, you may have an autoimmune disease; however, it does not indicate the particular disease one might be suffering from. Thus, the doctor might recommend testing for additional tests like the ones mentioned below-
- An anti-centromere test diagnoses scleroderma.
- The anti-double-stranded (ds) DNA test diagnoses lupus. Furthermore, C3 and C4 complement protein tests may also be ordered to confirm the diagnosis of lupus.
- Also, an ENA panel helps your doctor see which autoimmune disease you have.
Also, some drugs like sulphadiazines, procainamide, isoniazid, methyldopa, etc may be associated with a positive ANA test.
Conclusion
ANA or anti-nuclear antibodies are produced by the body’s immune system against itself, specifically against the nucleus (and also the cytoplasm). It has been used for nearly 50 years now and still remains one of the most important tests to evaluate patients with suspected connective tissue disorder, also referred to as ANA-associated rheumatic diseases (AARDs).
These include mixed connective tissue disease, systemic lupus erythematosus, scleroderma, Sjogren’s disease, drug-induced LE, etc. A positive or negative result does not solely indicate the presence or absence of an autoimmune disease. The doctor will have to correlate clinically and may need to perform more tests.
FAQs
A positive ANA test indicates that you have detectable anti-nuclear antibodies in your blood. This may be indicative of an autoimmune disorder. Some people with a positive ANA test may never develop an autoimmune disorder. Almost one-third of women above the age of 65 years test positive for the ANA test.
ANA-associated rheumatic diseases (AARDs) are associated with an ANA-positive test. These include mixed connective tissue disease, systemic lupus erythematosus, scleroderma, Sjogren’s disease, drug-induced LE, polymyositis, rheumatoid arthritis, Raynaud’s phenomenon, etc
A ratio of 1:640 or greater indicates a high possibility of autoimmune disorder. However, a positive result doesn’t always mean that you have an autoimmune disease. The results need to be clinically correlated before drawing a conclusion.
Yes, a positive ANA test may be associated with a few cancers like lung, breast, head, and neck cancer.
ANA stands for antinuclear antibodies. It is a type of autoantibody that is an antibody against self. These are produced against nuclear and cytoplasmic antigens and hence the name anti-nuclear.
How to book ANA Test?
Sources
A Basic Guide to ANA Testing | AACC.org
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628865/
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ANA Test
Dr Garima Saroj
Dr Garima Saroj is a dentist from Manipal college of dental sciences. She has previously worked at ESIC dental college and hospital Delhi and Dentecare multispecialty dental clinic Gurugram. She has a passion for writing for patient education and awareness.