Table 4.
Clinical utility of ANA testing in different diseases.
| Diagnosis | Clinical utility | ANA prevalence | Monitoring/prognosis | Comments |
|---|---|---|---|---|
| SLE | Very useful | 90–95% | Not useful | ANA IIF superior to ANA solid phase assays |
| SSc | Very useful | 85–95% | Not useful | ANA IIF superior to ANA solid phase assays |
| SjS | Useful | 50–60% | Not useful | ANA solid phase assays superior to ANA IIF; SS-A reactivity can be missed by ANA HEp-2 |
| AIM | Somewhat useful | 50–60% | Not useful | ANA solid phase assays superior to ANA IIF; Jo-1 reactivity can be missed by ANA HEp-2 |
| MCTD | Very useful | 90–100% | Not useful | High titer anti-U1-RNP are highly indicative for MCTD |
| JCA/JIA | Somewhat useful | 50–60% | Very useful | Useful for subset that are at risk of developing uveitis |
| PBC | Very useful | 50–80% | Not proven | ANA IIF superior to solid phase assays; Antibodies to SP100, gp210, nucleoporin p62, lamin B receptor and Ro52 /TRIM21. Anti-gp210 reported association with poor prognosis. |
| RA | Not useful | 15–20% | Not useful | Homogeneous and speckled staining are the most common patterns |
| APS | Not useful | 40–70% | Not useful | Might indicate systemic autoimmunity in primary APS patients |
| AT | Not useful | 10–20% | Not useful | Higher in Grave's disease as compared to Hashimoto`s thyroiditis |
| Cancer and paraneoplastic syndromes |
Not useful, or utility not established |
20–50% | Not useful | Antibodies to CENP-F and to other proteins might be useful to help in the diagnosis of cancer; p53 has been discussed; not many systematic studies on ANA in cancer |
| AIH | Useful | 40–80% | Not useful | Prevalence depends on phase of the disease |
Abbreviations: AIH: autoimmune hepatitis; AIM: autoimmune inflammatory myopathy (polymyositis, dermatomyositis); APS: anti-phospholipid syndrome; AT: autoimmune thyroiditis; JCA/JIA: juvenile chronic arthritis/juvenile inflammatory arthritis; MCTD: mixed connective tissue disease; PBC: primary biliary cirrhosis; RA: rheumatoid arthritis; SjS: Sjögren's syndrome; SLE: systemic lupus erythematosus; SSc: systemic sclerosis NOTE: Prevalence values are based on diagnostic samples (not treated patients).