Positive Anti-Nuclear Antibody (ANA) Test

Differential Diagnosis

Systemic lupus erythematosus (SLE): when active, usually a homogenous pattern on ANA or less commonly speckled, rim, or nucleolar when present in high enough titer to be clinically significant

Sjögren syndrome: common ANA pattern is speckled; less commonly homogenous

Scleroderma or systemic sclerosis: ANA pattern is most commonly speckled, followed by centromeric and less commonly nucleolar

Mixed connective tissue disease: ANA pattern is almost always speckled

Rheumatoid arthritis (RA): when ANA positive (about 25-40% of cases), a speckled ANA pattern most commonly

Don't Miss - Dangerous Situations

These are all chronic diseases, and, if there is a life-threatening complication, the complication could be serious.

Commonly Encountered Situations


  • Common autoimmune disorder

  • Much more common in women than men (female:male ratio approximately 9:1)

Suggested Additional Lab Testing

For follow-up from a positive ANA test:

  • For SLE: anti Ds DNA, anti-SS-A (Ro), anti-SS-B (La), anti-U1 RNP, anti-Sm, and follow-up with serial anti-DS DNA

  • For Sjögren syndrome: anti-SS-A (Ro), anti-SS-B (La)

  • For polymyositis and adult dermatomyositis: anti-Jo-1

  • For mixed connected tissue disease: test for anti-U1 RNP

  • For scleroderma: if there is a fine or grainy nuclear pattern, test anti-Scl-70 (topoisomerase I); if there is a centromeric pattern, no additional tests are recommended.

In addition to the follow-up with serologic testing, patients with Sjögren syndrome can be tested for dry eyes and dry mouth by a variety of assays.

Patients with possible inflammatory muscle disease may benefit from creatine kinase testing and/or a muscle biopsy. Evaluation for RA: rheumatoid factor test (found in approximately 80% of patients with RA); x-rays, particularly of hand and wrist for joint disease; C-reactive protein test as an indicator of inflammation with or without SED rate to assess level of inflammation.

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings


Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs