Antinuclear Antibody Testing: Methods and Pattern Interpretation (Online CE Course)
  (based on 839 customer ratings)
Author: Robert R. Boyes
Reviewer: Megan Goodner
Laboratory methods for detection and identification of antinuclear antibodies (ANA's) are complex. Proper training is required to correctly interpret results at both the laboratory and clinical level. This educational program provides a comprehensive review of the methods, interpretation, and clinical significance of ANA testing. The material presented will emphasize techniques and interpretation and will be of practical use to laboratory technologists, pathologists, clinicians, and rheumatologists.
The slides being used in this course are courtesy of Immuno Concepts. Any reproduction, storage, or use beyond this course is prohibited.
Continuing Education Credits
- P.A.C.E.® Contact Hours (acceptable for AMT, ACSP / NCA, and state recertification): 2 hour(s)
- Florida Board of Clinical Laboratory Science - General (Serology/Immunology): 2 hour(s)
Objectives
- Explain the differences in antinuclear antibody (ANA) methods.
- Distinguish positive from negative samples.
- Identify and classify ANA patterns.
- Discuss the clinical significance of ANAs.
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Course Outline
- Introduction to ANA testing
- Copyright and Disclosures
- Autoimmune Diseases
- Autoimmune Disease (continued)
- Systemic Autoimmune Rheumatic Diseases
- Antinuclear Antibody Test
- Which of these is NOT considered one of the systemic autoimmune rheumatic diseases?
- Which of these may contribute to the development of an autoimmune disease? (Choose all that apply)
- ANA Testing Methods
- History of ANA Testing
- Fluorescent ANA Testing
- Colorzyme®
- Other Methods for ANA Testing
- Understanding the ANA Substrate
- Cell Morphology
- Stages of Mitosis
- Which two stages of cell division are the most important for reading ANAs?
- ANA Pattern Interpretation
- Reading ANA Patterns Using a HEp-2 or HEp-2000® Substrate
- For the ANA test to be positive what must be present in the nucleus of the interphase cell?
- ANA Testing Scheme
- Why are ANA positive samples titered?
- Follow-up Testing
- Antigen Chart
- What type of follow-up testing is recommended for a Speckled ANA pattern?
- ANA Patterns
- ANA patterns
- Negative
- Homogeneous
- Speckled
- Nucleolar
- Centromere
- SSA/Ro Pattern
- Proliferating Cell Nuclear Antigen (PCNA)
- Nuclear Membrane
- The image on the right represents the result of a fluorescent antinuclear antibody (ANA) test. What pattern should be reported?
Note: (a) points to t...
- Unusual or Atypical Speckled Patterns
- Overview
- NSp I or Multiple Nuclear Dots (MND)
- NSp II or CENP-F
- Nuclear Matrix
- Midbody
- Other Unusual ANA Patterns
- When identifying the Midbody pattern only cells in interphase and metaphase are useful.
- Mixed ANA Pattterns
- Overview
- Homogeneous and Speckled
- Homogeneous and Centromere
- Homogeneous and SSA/Ro (on HEp-2000®)
- Speckled and SSA/Ro
- Scl-70
- Other Mixed Patterns
- What is the most common combination of ANA patterns?
- Cytoplasmic Patterns
- Overview
- Cytoskeletal
- Mitochondrial
- Ribosomal P
- Golgi
- Mitotic Spindle
- NuMA
- HsEg5
- Cytoplasmic patterns are interesting to look at but have no clinical significance and should NOT be reported.
- References
Additional Information
Level of instruction: Intermediate
Intended Audience: Clinical laboratory professionals including medical laboratory scientists and medical laboratory technicians, This course is also appropriate for clinical laboratory science and MLT students. Author information: Robert R. Boyes is the Sr. Vice President and General Manager for Immuno Concepts located in Sacramento, California. He holds a degree in Medical Technology. In his career as a clinical laboratory professional, he has worked in hospital laboratories, specialty clinics, and in the corporate setting. Mr. Boyes has conducted numerous research presentations and has authored or co-authored several publications related to antinuclear antibodies. Reviewer information: Megan Goodner is the laboratory manager for Immuno Concepts. Course Description: Laboratory methods for detection and identification of antinuclear antibodies (ANA's) are complex. Proper training is required to correctly interpret results at both the laboratory and clinical level. This educational program provides a comprehensive review of the methods, interpretation, and clinical significance of ANA testing. The material presented will emphasize techniques and interpretation and will be of practical use to laboratory technologists, pathologists, clinicians, and rheumatologists.
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