Determining the pattern of the ANA is done by the lab. When your results were reported, it should have included the pattern. Most labs will use the immunofluorescent (IFA) technique for testing ANA. The staining patterns in these tests offer specific clues as to which particular antinuclear antibody or antibodies may be present. The specific autoantibody that's present, in turn, gives the physician information as to what autoimmune disease may be present or what other specific autoantibody tests need to be performed. In some cases, more than one autoimmune disease (overlap syndromes) may be present, which causes more than one ANA pattern to be present in a sample. Some patterns are more specific for particular diseases than others. For example, in SLE, a homogeneous pattern is present, whereas a nucleolar pattern is seen in scleroderma and a centromere pattern in the CREST variant of scleroderma. The type of pattern determines what antibodies might be present. For instance, in a homogeneous pattern, anti-DNA antibodies are possible and this test would be recommended, whereas it would not be recommended in patients who have a speckled pattern ANA. The most common secondary antibody tests performed based on ANA results include: anti-DNA, anti-Sm, anti-RNP, SS-A and SS-B.
As SITC mentioned, Lupus is a very difficult disease to diagnose, partly because its symptoms and lab results could also indicate so many other auto-immune disorders. Antinuclear antibodies (ANA) can occur in a number of different autoimmune disorders including systemic lupus erythematosus (SLE) and Sjogren's syndrome (as explained above). Because many lupus symptoms mimic other illnesses, are sometimes hard to determine and may come and go, lupus diagnoses must include a careful review of a your entire medical history coupled with an analysis of the results obtained in routine laboratory tests and some specialized tests related to immune status.
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