Connective Tissue Diseases - Systemic Autoimmune Rheumatic Diseases

ARUP Consult clinical decision support for SARD laboratory testing. Recommends IFA on HEp-2 as gold-standard ANA screen in high pretest-probability patients, compares IFA/ELISA/CLIA/multiplex methods, and maps patterns to autoantibodies and diseases. Candidate notes: ANA testing is best used when pretest probability of SARD is high because ANA can occur in healthy people and in infection, cancer, and other autoimmune disease. IFA is described as the gold standard and is recommended by ACR for evaluation of several SARDs. Immunoassays are generally less sensitive but more specific, faster, and more objective than IFA. Positive immunoassay with negative IFA generally has low positive predictive value for SARDs. In high clinical suspicion, specific autoantibody testing should proceed even if ANA is negative. ANA IFA reports should include method, substrate, qualitative result, pattern(s), and titers. Page includes pattern-antigen-disease association tables for nuclear and cytoplasmic patterns. Limits noted in the record: Lab-affiliated guidance reflecting ARUP menus; last literature review April 2021 with July 2025 update note. A positive ANA is not a diagnosis. Claims in this record are not verified.

A positive ANA is not a diagnosis. Claims in this record are not verified.

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