The global market for ANA testing is projected to grow from USD 823.5 million in 2016 to USD 1,476 million by 2021, driven by factors such as the increasing incidence of autoimmune diseases and rising healthcare spending. While a positive ANA test indicates potential autoimmune conditions, it is not definitive proof of any disease, as positive results can be influenced by various factors, including age and other health issues. Clinicians are advised to exercise caution in diagnosing based solely on ANA results and ensure thorough patient evaluation.

1. ANA testing
Myths &
Pitfalls

2. The
Global market for ANA testing
2021 - is expected to reach USD
1,476 Million vs 823.5 Million in 2016
Growth market is primarily driven by
?high incidence of autoimmune
diseases
?growing population
?healthcare spending
?growth in the number of individuals
covered under medical insurance in
the U.S.

3.  1988-2012 aprox 14200 people tested for ANA
 13% (1976 people) +ANA >1:80
 Prevalence increased from 11% in 1988 to 11.5% in 1999
to 15.9% in 2012 which corresponds to ~22 million, ~27
million, and ~41 million affected individuals

5. Is ANA a
good
screening
test for
autoimmune
disease?

6. Joint pain ?
Rash?
Muscle pain?
 Unexplained
fatigue?

7. Now you have +ANA…
What should you do next?

9. 1:40
1:80
1:160
1:320
1:640+
Titers

10. ANA Titers in
healthy
people
 ANA 1:40: 20% to 30%
 ANA 1:80: 10% to 15%
 ANA 1:160: 5%
 ANA 1:320: 3%
 Elderly (>age 70): up to 70%
positive at ANA titer 1:40
 Small % of elderly with
autoimmune disease
 Childbearing age

11. SIGNIFICANCE OF STAINING PATTERNS?
Centromere
Rim
Homogenous Nucleolar Speckled

12. Speckled
Sjogren
SLE
Correlations
Homogenoue
s
SLE
DILE
Nucleolar
Scleroderma
Myositis
SLE
Rim
SLE
Centromere
CREST
PBC

13. Most frequent causes of +ANA
 CANCERS
 Lymphoma
 Solid organ cancers
 s/p Radiation therapy
 DRUGS
 Drug induced lupus
 Drug induced
 AUTOIMMUNITY
 Connective tissue diseases
(SLE)
 Thyroid autoimmune disease
 Liver autoimmune disease
(PBC, AHA)
 Multiple sclerosis
 CHRONIC INFECTIONS
 SBE
 TB
 Histoplasmosis
 Mononucleosis

14. ANA positive is NOT lupus!
As
Lupus without positive ANA is
NOT lupus!
Maybe….extremely rare
(<1%)!

18. Handout to
patients
 Anti-nuclear antibodies (ANA)
are possible signs of
autoimmune diseases
 A negative ANA test result
means no auto- antibodies
are present.
 One positive ANA test result is
not a sure sign of autoimmune
disease, so you may not need
any immediate treatment

21. DISCLAIMER
 Please note that these rheumatology discussions are for informational and
educational purposes only. The discussions are based on limited information
and exclude patient observation and hands-on clinical evaluation. As such,
comments relating to patient care, evaluation, planning and treatment should
be regarded as a professional dialogue only. Physicians attending the
discussions shall remain in complete control of medical services they provide
to their patients and shall be solely responsible for all acts and decisions in
connection therewith.
Licensed in CA, OH, IN and KY
Soon in AZ and TX

22. Thank you!
Rheumatologist Oncall
Office phone: 1-650-252-1690
drg@rheumatologistoncall.com
https://dianagirnitamd.com