How AVISE CTD Can Help After a Positive ANA Test

For many people with autoimmune disease symptoms, receiving a diagnosis typically involves having an antinuclear antibody (ANA) test. This widely used laboratory test checks for many different autoimmune diseases. A positive ANA test could mean you have a condition such as lupus, scleroderma, Sjögren’s syndrome or rheumatoid arthritis, among others.1

Although ANA tests have been administered for many years, they are not perfect. A test like AVISE® CTD, which uses patented tests to pinpoint specific antibodies, can be an effective next step for people seeking answers.

What is an ANA Test?

During an ANA test, your doctor takes a blood sample to look for antinuclear antibodies, which are proteins that can result in damage to your cells and tissues. The term “antinuclear” refers to autoantibodies that react with a cell’s nucleus.2,3

Your body makes antibodies when it thinks the immune system is fighting an infection, but it can also create antibodies in response to autoimmune diseases, conditions that occur when the immune system attacks normal body tissues by mistake. When you have an autoimmune disease, your body makes antibodies that attack healthy cells, muscles, joints, glands and organs, causing inflammation.4

ANA tests use a technique called immunofluorescence, which allows healthcare professionals to see fluorescent chemicals that light up when attached to antibodies.5 Although the results can help identify the presence of inflammatory disorders, they can’t, by themselves, tell your doctor which disease is causing your symptoms.

When ANA Tests Are Ordered

Your doctor may order an ANA test if you have symptoms of an autoimmune condition, such as fatigue and joint pain. The ANA test will reveal if antinuclear antibodies could be behind your symptoms and can help identify conditions, including:
  • Rheumatoid arthritis: This chronic condition causes pain and stiffness in certain joints, such as your hands and feet. However, there are many ways rheumatoid arthritis can affect your body.6
  • Scleroderma: Scleroderma is an autoimmune disease that affects your skin's connective tissue.7
  • Sjögren’s syndrome: With this condition, the immune system targets moisture-producing glands in the eyes and mouth, among other areas, leading to dryness, burning and itching.8
  • Systemic lupus erythematosus (SLE): The most common form of lupus, SLE is characterized by inflammation in various parts of the body along with other symptoms, including fevers and joint pain.

What Positive ANA Test Results Mean

If your ANA test is positive, it means you have antinuclear antibodies circulating in your system. It can indicate an underlying autoimmune disease or connective tissue disorder, such as lupus.

However, a positive result can’t differentiate between lupus or another autoimmune condition. As many as 40+ million people in the U.S., about 15% of the general population, will test positive for antinuclear antibodies.2 You can have a positive ANA test result for other reasons, including:3

  • Age. The presence of antinuclear antibodies increases with age, particularly after age 65.
  • Medication use. Certain medications, including diuretics, some antidepressants and hormones, can increase the presence of antinuclear antibodies.9
  • Other illnesses. Viruses, infectious diseases and some types of cancer can cause your body to produce antinuclear antibodies.10,11

Generally, a positive ANA test is an indication that other tests are needed to investigate further.

Negative ANA Test Results

A negative ANA test result means there were no traces of antinuclear antibodies in your system and that, when the test was taken, your likelihood of having lupus is relatively low.

Because so many people with autoimmune diseases have antinuclear antibodies, negative results can help rule out autoimmune conditions.2  However, some people with lupus and other autoimmune diseases will get a negative ANA test result when they are first tested. They may have certain types of antibodies that an ANA test does not look for:

  • Antiphospholipid syndrome
  • Autoimmune thyroid diseases, such as Graves’ disease and Hashimoto’s thyroiditis
  • Mixed connective tissue disease
  • Myositis
  • Rheumatoid arthritis
  • Sjögren’s syndrome
  • Systemic sclerosis

As a result, the test can offer more information than an ANA test and provide the information needed to make a confident diagnosis of a specific condition.

Accuracy You Can Trust

The AVISE CTD test allows your doctor to offer a more definitive diagnosis that not only sets you on the right path for treatment but also reduces the need for repeat testing. Research has also shown tests like the AVISE CTD help improve patient care resulting in improvements in patient-reported quality of life scores,12  which means their results can help you experience less depression and anxiety related to your symptoms.
If you think you have an autoimmune condition, our symptoms checklist can help you document your symptoms so you can share them with your provider. Then, request a conversation guide to discuss the next steps with your healthcare provider.
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Last reviewed by an Exagen subject expert on 02/07/2023.

Footnotes:

  1. American College of Rheumatology. Antinuclear Antibodies (ANA). Updated December 2021. Accessed January 3, 2023. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Antinuclear-Antibodies-ANA
  2. National Library of Medicine MedlinePlus. ANA (Antinuclear Antibody) Test. MedlinePlus. Updated August 3, 2022. Accessed January 3, 2023. https://medlineplus.gov/lab-tests/ana-antinuclear-antibody-test.
  3. Lupus Research Alliance. ANA Testing. Accessed January 3, 2023. https://www.lupusresearch.org/understanding-lupus/what-is-lupus/diagnosis/ana-testing.
  4. American College of Rheumatology. Patient Fact Sheet: Anti-nuclear Antibodies (ANA). Updated March 2019. Accessed January 3, 2023. https://www.rheumatology.org/Portals/0/Files/Antinuclear-Antibodies-ANA-Fact-Sheet.pdf.
  5. Im K, Mareninov S, Diaz MFP, Yong WH. An Introduction to Performing Immunofluorescence Staining. Methods Mol Biol. 2019;1897:299-311. doi:10.1007/978-1-4939-8935-5_26
  6. Centers for Disease Control and Prevention. Rheumatoid Arthritis (RA). Accessed January 3, 2023. https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html.
  7. NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases. Scleroderma. Accessed January 3, 2023. https://www.niams.nih.gov/health-topics/scleroderma.
  8. NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases. Sjögren’s Syndrome. Accessed January 3, 2023. https://www.niams.nih.gov/health-topics/sjogrens-syndrome.
  9. Dinse GE, Parks CG, Meier HCS, et al. Prescription medication use and antinuclear antibodies in the United States, 1999-2004. J Autoimmun. 2018;92:93-103. doi:10.1016/j.jaut.2018.05.006
  10. Im JH, Chung MH, Park YK, et al. Antinuclear antibodies in infectious diseases. Infect Dis (Lond). 2020;52(3):177-185. doi:10.1080/23744235.2019.1690676
  11. Gauderon A, Roux-Lombard P, Spoerl D. Antinuclear antibodies with a homogeneous and speckled immunofluorescence pattern are associated with lack of cancer while those with a nucleolar pattern with the presence of cancer. Front Med. 7:165. doi:10.3389/fmed.2020.00165
  12. Wallace DJ, Alexander RV, O'Malley T, et al. Randomised prospective trial to assess the clinical utility of multianalyte assay panel with complement activation products for the diagnosis of SLE. Lupus Sci Med. 2019;6(1):e000349. Published 2019 Sep 19. doi:10.1136/lupus-2019-000349