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Quest Diagnostics

ANA Multiplex, with Reflex to dsDNA

Quest Diagnostics

Sample type: Serum

Requires fasting: No

Phlebotomy required

Details

ANA Multiplex, with Reflex to dsDNA - This multiplex immunoassay detects common antinuclear antibodies (ANAs) that are associated with autoimmune diseases. With a reflex to double-stranded DNA (dsDNA), this test may aid in the evaluation of systemic lupus erythematosus (SLE).

Reflex testing uses predefined clinical logic to automatically order one or more follow-up tests based on the initial test results. Reflex tests are performed automatically without the intervention of the ordering practitioner. They are conducted using the same sample your Patient already provided. If reflex tests are required, there will be additional charges.

Initial test
  • Antinuclear Antibodies Screen (Immunoassay)
Possible reflex biomarkers
  • DNA (ds) Antibody

Estimated days for results: Results should be available in 2 - 5 business days after the sample is collected

Details
ANA Multiplex, with Reflex to dsDNA - This multiplex immunoassay detects common antinuclear antibodies (ANAs) that are associated with autoimmune diseases. With a reflex to double-stranded DNA (dsDNA), this test may aid in the evaluation of systemic lupus erythematosus (SLE). Because of its limited sensitivity compared to that of ANA immunofluorescence-based tests, multiplex immunoassay is not the preferred assay for ANA testing [1].

This multiplex immunoassay identifies antibodies to dsDNA, chromatin, ribosomal protein, SSA, SSB, Sm, Sm/RNP, RNP, Scl-70, Jo-1, and centromere B. A positive result indicates the presence of at least one of these autoantibodies. These autoantibodies have been associated with several autoimmune diseases, including SLE, systemic sclerosis, mixed connective tissue disease, polymyositis, and Sjogren syndrome. Antibodies to dsDNA are highly specific for SLE and may be detected before flares of the disease [2]. The 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria include antibodies to dsDNA in their immunology domains and criteria for SLE [3].

A negative result of this test indicates none of the component autoantibodies were detected but does not rule out the autoimmune diseases characterized by other autoantibodies, such as autoimmune hepatitis and primary biliary cholangitis. The classic ANA immunofluorescence assay on human epithelial type 2 cells, an assay that can detect up to 150 antibodies, is considered by the ACR as the current gold standard for ANA testing [1].

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.
2. Tozzoli R, et al. Am J Clin Pathol. 2002;117(2):316-324.
3. Aringer M, et al. Ann Rheum Dis. 2019;78(9):1151-1159.

What type of sample is required for this test?
1 mL serum

Test Resources
For more information, please consult your healthcare provider.

2–5 business days

ANA Screen, Immunoassay         Negative
  • Autoimmune

Blood Draw Options with Fullscript
Fullscript offers several convenient phlebotomy options to complete your lab testing:

Quest Diagnostics Patient Service Centers (PSC)

  • Location: Visit a nearby Quest Diagnostics Patient Service Center.
  • Cost: $10 sample collection fee (paid during lab order checkout).
  • Scheduling: Schedule your appointment here. Appointments are recommended to reduce wait times. Walk-ins are accepted, but may experience delays. Aim to arrive 10 minutes before your appointment.
  • Collection Instructions:
    • Bring a valid ID.
    • Bring your digital or printed requisition form, available in the Labs tab of your Fullscript account.
  • Check-in: Scan the QR code from your confirmation email or follow kiosk instructions.
  • More Info: Quest Diagnostics blood draw guide

Getlabs Mobile Phlebotomy

  • Location: Sample collection at your home or office.
  • Cost: $85 sample collection fee (paid during lab order checkout).
  • Availability: Available in most locations – enter your ZIP code during checkout to confirm.
  • Scheduling: Schedule your appointment here through your Fullscript account.
  • Collection Instructions:
    • Have your digital or printed requisition form and valid ID ready.
    • Your phlebotomist will contact you by phone to coordinate arrival.
  • More Info: Getlabs blood draw guide
 Specimen
  • Preferred Specimen(s): 1 mL serum 
  • Alternative: NA 
  • Minimum Volume: 0.5 mL 
  • Collection Instructions: NA 
 Storage and shipping instructions
  • Transport Container: Transport tube 
  • Transport Temperature: Room Temperature 
  • Specimen Stability: 
    • Room temperature: 4 days 
    • Refrigerated: 7 days 
    • Frozen: 30 days 
  • Reject Criteria: 
    • Gross hemolysis • Grossly lipemic • Grossly icteric 
State restrictions:

Patient can't order this test if they are located in Hawaii, Puerto Rico, New Jersey, New York, or Rhode Island

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