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ANAchoice® Panel 1 With Reflexes
Test CodeCPT Codes
86038, 86235 (x5), 86255, 86431
Includes
Rheumatoid Factor
DNA (ds) Antibody, Crithidia IFA with Reflex to Titer
Sm Antibody
Sm/RNP Antibody
Scleroderma Antibody (Scl-70)
Sjogren's Antibodies (SS-A, SS-B)
If the ANAchoice® Screen is positive, ANA titer and pattern will be performed at an additional charge (CPT code(s): 86039).
If the DNA (ds) Antibody Screen is positive, DNA (ds) Antibody Titer will be performed at an additional charge (CPT code(s): 86256).
Preferred Specimen
Patient Preparation
Overnight fasting is preferred
Minimum Volume
Transport Temperature
Room temperature
Specimen Stability
Refrigerated: 7 days
Frozen: 30 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Methodology
See individual tests
Setup Schedule
Clinical Significance
This panel can be helpful in the diagnosis of autoimmune rheumatic diseases, including systemic lupus erythematosus, systemic sclerosis, Sjogren syndrome, mixed connective tissue disease, and rheumatoid arthritis. All specimens are screened for antinuclear antibodies (ANAs) with multiplex immunoassay. This approach simultaneously detects antibodies to dsDNA, chromatin, ribosomal protein, SSA, SSB, Smith (Sm), Sm/RNP, RNP, Scl-70, Jo-1, and centromere B. A positive result indicates the presence of at least 1 of these antibodies; a negative result indicates that none of the component antibodies were detected. Regardless of the result, this panel also detects antibodies to dsDNA, Sm, Sm/RNP, Scl-70, SSA and SSB as well as rheumatoid factor.
ANA immunofluorescence assay (IFA) on HEp-2 cells is considered by the American College of Rheumatology as the current gold standard for ANA screening because of its overall high sensitivity for several autoimmune diseases [1]. However, because patients with other diseases and healthy individuals may be positive for ANA IFA, using immunoassays for screening may be more specific for a systemic rheumatic disorder [2]. On the other hand, multiplex immunoassay screening cannot rule out autoimmune diseases characterized by other antibodies, such as autoimmune hepatitis and primary biliary cholangitis, which may be positive for ANA IFA.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. Methodology of testing for antinuclear antibodies (position statement). 2009. American College of Rheumatology. Updated December 2019. Accessed May 15, 2023. https://assets.contentstack.io/v3/assets/bltee37abb6b278ab2c/blta48818378bc89445/acr-position-statement-methodology-testing-antinuclear-antibodies.pdf
2. Fritzler MJ, et al. J Appl Lab Med. 2022;7:357-361.
