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Medical Laboratory for Autoimmune Diseases

Medical lab testing blood samples in production for autoimmune testing.

 

Autoimmune Diseases

 

We support subspecialty physicians in the diagnosis and management of autoimmune diseases through comprehensive and reliable testing services. Our advanced autoimmune panels include Antinuclear Antibody (ANA) testing, a critical first step in detecting autoimmune activity and guiding further diagnostic evaluation.

With precise results and efficient turnaround times, we help clinicians identify complex autoimmune conditions and make timely, informed decisions for their patients' care.

 

ANA Screen, IFA, with Reflex to Titer and Pattern

 

Overview

The Antinuclear Antibody (ANA) Screen by Indirect Immunofluorescence Assay (IFA) is a commonly used laboratory test to help evaluate individuals who may have an underlying autoimmune condition. At ExpressLab, this test is performed using human epithelial (HEp-2) cells, the method recognized by the American College of Rheumatology as the preferred standard due to its high sensitivity.

Why This Test Is Ordered

ANA testing is often one of the first steps when symptoms suggest a possible autoimmune disorder. Antinuclear antibodies are frequently present in conditions where the immune system mistakenly targets the body's own tissues.

Autoimmune conditions commonly associated with positive ANA results include:

Because ANAs can be present across multiple autoimmune diseases, the ANA screen serves as a valuable starting point in the diagnostic process.

ANA Titers and Pattern Insights

When ANA antibodies are detected, the result is reported as a “titer,” which reflects the concentration of antibodies in the blood. Titers of 1:40 or greater are considered positive. However, low-level positive results may occasionally be seen in healthy individuals, particularly as people age.

Higher ANA titers are more strongly associated with autoimmune disease and may warrant further evaluation. In addition to the titer, the fluorescent staining pattern observed during testing provides important diagnostic clues. Specific nuclear or cytoplasmic patterns can help guide clinicians toward additional targeted antibody testing and support more precise diagnosis.

ExpressLab follows internationally recognized standards for ANA pattern interpretation to ensure consistent, reliable reporting.

Negative Results and Additional Testing

A negative ANA IFA result generally indicates that additional autoimmune antibody testing is not necessary in the absence of strong clinical suspicion. Most individuals with negative ANA results will also test negative for more specific autoantibodies.

In limited cases, certain antibodies, such as Jo-1 (associated with some inflammatory muscle diseases) or SSA (sometimes present in lupus or Sjögren syndrome), may be detected even when the ANA screen is negative. These situations are evaluated based on symptoms and clinical judgment.

Test Details

Includes:

Reflex Testing:

 

ANA Multiplex, Panel 1 with Reflexes

 

Overview

The ANA Multiplex, Panel 1 with Reflexes is a comprehensive blood test used to support the evaluation of autoimmune rheumatic diseases. At ExpressLab, this panel uses advanced multiplex immunoassay technology to simultaneously screen for multiple disease-specific autoantibodies, offering a targeted approach to autoimmune assessment.

Why This Test Is Ordered

This panel is commonly ordered when there is clinical concern for a systemic autoimmune or connective tissue disorder. Unlike traditional ANA screening methods, multiplex testing focuses on identifying specific autoantibodies that are more closely associated with defined autoimmune diseases.

Conditions commonly associated with antibodies included in this panel include:

What the Test Measures

All specimens are initially screened for antinuclear antibodies using a multiplex immunoassay. This method allows for the simultaneous detection of antibodies directed against multiple nuclear and cytoplasmic targets.

The panel screens for antibodies including, but not limited to:

A positive result indicates the presence of one or more of these antibodies. A negative result means none of the listed antibodies were detected. In addition to ANA-associated antibodies, this panel also includes rheumatoid factor testing to support evaluation for inflammatory arthritis.

Multiplex Testing vs. ANA IFA

The American College of Rheumatology recognizes the ANA immunofluorescence assay (IFA) performed on HEp-2 cells as the most sensitive method for ANA screening. However, ANA IFA can also yield positive results in healthy individuals or those without systemic autoimmune disease.

Multiplex immunoassay screening may offer greater specificity for certain rheumatic conditions by identifying disease-associated antibodies directly. However, multiplex testing does not detect all possible ANA patterns and may not identify autoimmune diseases associated with antibodies outside the panel, such as autoimmune hepatitis or primary biliary cholangitis. For this reason, test selection is best guided by clinical symptoms, history, and provider judgment.

Interpreting Results

Results from the ANA Multiplex Panel should always be interpreted alongside a patient's medical history, family history, physical examination, and other laboratory findings. No single test is diagnostic on its own, but this panel can provide valuable direction for further evaluation and management.

Test Details

Includes:

Reflex Testing:

 

Express Lab Advantage

Express Lab delivers comprehensive autoimmune testing with high-sensitivity and targeted assay options, providing clear, clinically meaningful results to support accurate diagnosis and informed care decisions. For assistance with test selection, coding, or collection instructions, providers are encouraged to contact us directly at 208-529-8330 or fill out the online form.