Positive ANA test

What is an ANA test?

Antibodies are proteins your immune system makes to fight germs. Sometimes the immune system makes antibodies that target your own cells by mistake. These are called autoantibodies¹. Antinuclear antibodies (ANA) are a type of autoantibody that targets the center, or nucleus, of your cells².

An ANA test is a simple blood draw from your arm³. Clinicians often order it when someone has symptoms that could come from an autoimmune disease³.

Symptoms that often lead to an ANA test

A positive ANA by itself causes no symptoms. Clinicians usually order the test because of symptoms such as³:

• Joint pain, stiffness, or swelling
• Feeling very tired
• Fever
• Rashes or skin color changes
• Muscle pain
• Swollen glands

If you had an ANA test as part of a routine checkup without symptoms, a positive result is less likely to mean disease^1,3.

Causes of a positive ANA

A positive ANA can show up with^1,2,3:

• Autoimmune diseases, such as lupus, Sjögren’s, scleroderma, rheumatoid arthritis, and dermatomyositis (a muscle and skin disease)
• Viral infections, which may cause a short-term positive result
• Some medicines
• Some other health conditions, including certain cancers
• No disease at all

Positive results are common in healthy people. Up to 15 percent of healthy people test positive¹. The chance rises with age, especially after 65^1,3. Only about 11 to 13 percent of people with a positive ANA have lupus or another autoimmune disease¹.

How a positive ANA is evaluated

Your result report usually has three parts²:

• Positive or negative
• The titer, written as a ratio like 1:160. A higher second number means more antibodies
• The pattern, which describes how the antibodies look under a microscope. Some patterns point toward certain diseases

A rheumatologist then puts the result together with your story and an exam¹. Next steps may include^2,4,5:

• More specific antibody tests, such as anti-double-stranded DNA (anti-dsDNA), anti-Smith, anti-SSA (Ro), and anti-SSB (La)
• Blood counts, kidney tests, and tests that measure inflammation
• A urine test

A negative ANA makes lupus unlikely, since more than 95 percent of people with lupus test positive¹.

Treatment options

A positive ANA on its own is not a disease, and it usually doesn’t need treatment¹. Treatment depends on whether a specific condition is found^1,2.

• If no autoimmune disease is found, your clinician may suggest watching for new symptoms¹.
• If a condition like lupus or Sjögren’s is found, treatment is planned for that condition.

Living with a positive ANA and when to get care

Waiting for answers can be stressful. A positive ANA alone is not a sure sign of autoimmune disease¹.

If you have a positive ANA and symptoms like joint pain or swelling, rashes, mouth sores, or fevers that keep coming back, ask your clinician whether you should see a rheumatologist. Bring a list of your symptoms and when they started. Don’t stop any medicine before a test unless your clinician tells you to³.