Antinuclear Antibody

A positive ANA does not diagnose an autoimmune disease nor does a negative result exclude it; however, the ANA is positive in 99% of patients with Systemic Lupus Erythematosus, which means a negative result strongly argues against such a diagnosis. 

ANA can be positive by definition in 5% of the healthy population, typically in titers less than 1:320.  Up to 20% of healthy relatives of patients with rheumatic disease and up to 75% of healthy individuals older than 70 will have a positive ANA (typically less than 1:80 with a speckled or homogenous pattern). 

Other conditions associated include:

  • thyroid disease
  • chronic infections including TB/viral hepatitis
  • subacute bacterial endocarditis
  • malignancies
  • any of the auto-immune disease
  • multiple sclerosis 
  • silicone breast implants. 

In the absence of physical or biochemical evidence of pathology, a positive ANA is not clinically useful, i.e you do not treat the lab result, only symptoms or a disease.

Since there are no labs tests that prove you do or do not have a diagnosis of Lupus or other rheumatological diseases, a frequent reason for referral to a rheumatologist is to determine the cause of a positive ANA.