ANA Multiplex with Reflex to 11 Antibody Cascade
- $39.75
The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.
Also known as: AnachoiceR Specific Ab Cascading Reflex
Anachoice(R) Screen
The ANA Multiplex with Reflex to 11 Antibody Cascade test contains 1 test with 1 biomarker .
Includes
If the ANA Screen, Immunoassay is positive, it will reflex the following five antibodies at an additional charge: dsDNA, Sm/RNP, RNP, Sm, and Chromatin.
If any of those five antibodies are positive, the cascade stops and the results are reported.
If all five of those antibodies are negative, four additional antibodies will be reflexed at an additional charge: SSA , SSB, Scl-70, Jo-1.
If any of those four antibodies are positive, the cascade stops and the results are reported.
If all four of those antibodies are negative, the following two additional antibodies will be reflexed at an additional charge: Ribosomal P and Centromere B.
The cascade stops upon the first positive antibody found in a group. It is possible that antibodies in subsequent groups are also positive, but will not be added or reported. Please contact your local Quest Diagnostics Laboratory if you are interested in adding this additional testing.
Clinical Significance
ANA Multiplex with Reflex to 11 Antibody Cascade - This panel can be helpful in the diagnosis of autoimmune rheumatic diseases, including systemic lupus erythematosus, systemic sclerosis, Sjogren syndrome, mixed connective tissue disease, and rheumatoid arthritis. All specimens are screened for antinuclear antibodies (ANAs) with multiplex immunoassay. This approach simultaneously detects antibodies to dsDNA, chromatin, ribosomal protein, SSA, SSB, Smith (Sm), Sm/RNP, RNP, Scl-70, Jo-1, and centromere B. A positive result indicates the presence of at least 1 of these antibodies; a negative result indicates that none of the component antibodies were detected.
Specimens with positive results are subsequently tested for a series of disease-specific autoantibodies in cascade tiers. The first tier focuses on autoantibodies associated with systemic lupus erythematosus (SLE) and mixed connective tissue disease; the second tier detects autoantibodies seen in Sjogren Syndrome, progressive systemic sclerosis and polymyositis; and the third tier include markers of the limited form of systemic sclerosis and neuropsychiatric SLE. Note that the cascade stops with the first tier in which a positive antibody result is observed. Therefore, even if an antibody included in a subsequent tier is present, it will not be reported with this test.
ANA immunofluorescence assay (IFA) on HEp-2 cells is considered by the American College of Rheumatology as the current gold standard for ANA screening because of its overall high sensitivity for several autoimmune diseases. However, because patients with other diseases and healthy individuals may be positive for ANA IFA, using immunoassays for screening may be more specific for a systemic rheumatic disorder. On the other hand, multiplex immunoassay screening cannot rule out patients with autoimmune diseases characterized by other antibodies, such as autoimmune hepatitis and primary biliary cholangitis, which may be positive for ANA IFA.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.