Cascading Policy for Anti-Nuclear Antibodies (Aug. 2005)

All requests for nuclear antibodies (ANA, DNA and ENA) will first be tested using HEp-2000 cells unless the request originates from Harrogate, Pinderfields or Pontefract Hospitals.

Samples found to be negative will undergo no further testing - unless there is a specific request for antibodies that may be missed by immunofluorescence e.g. Anti-Scl-70 and anti-Jo-1, supported by appropriate clinical information.

New patient samples found to be positive will have the pattern reported and will undergo, further testing for ENA and DNA by ELISA.

Repeat requests

Samples known to be ANA positive but NEGATIVE for dsDNA and ENA will NOT have dsDNA and ENA repeated unless:

  • change in clinical status is indicated on the request form
  • the last dsDNA test was more than 6 months previously
  • the last ENA test was more than 12 months previously

Samples known to be ANA positive and POSITIVE for dsDNA and/or ENA will ONLY have dsDNA and/or ENA repeated automatically in the following situations:

  • change in clinical status indicated on the request form
  • the last dsDNA test was more than 1 month previously
  • the last ENA test was more than 12 months previously

Samples from patients with RA or Crohn’s disease treated with “biologics” will be tested for anti-DNA antibodies every 6 months.

ANA Update 11.5.09:

Weak Positive ANA


Page updated: 01/01/11 | Updated by: Anna McHugh