The Anti-Nuclear Antibody (ANA) Test

By Richard Silver, M.D., Professor of Medicine, Medical University of South Carolina (originally published in Scleroderma Voice, 2002 Issue #1)

Question: When you have a positive ANA titer (concentration), can the pattern change, and if so, what does this mean? Is the pattern of the titer indicative of the disease you could develop?

Answer: Both the pattern and the titer (concentration) may change, and certain patterns are indicative of specific autoimmune diseases.

For example, the anti-centromere and the anti-nucleolar patterns are fairly specific for scleroderma, but other patterns such as the speckled pattern may be seen in both scleroderma and other connective-tissue diseases.

Generally, the ANA test is used by the rheumatologist to help support or refute a clinical impression; neither the pattern nor the titer is used to monitor the course of disease. Changes in pattern and titer are relatively insensitive, and therefore not very useful for the clinician.