ANAs and Autoantibodies Save
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Check out the accompanying Advanced Practice Rheum: Antinuclear Antibodies video. This video reviews autoantibody testing in rheumatology, emphasizing that ANA is highly sensitive (98%) but poorly specific (57%) for lupus—while 99.9% of lupus patients are ANA-positive, only 1 in 100 positive ANAs indicates lupus. The key message is to order ANA only when lupus criteria are clinically present, avoid screening asymptomatic patients or those with isolated arthralgia, and recognize that low titers are nonspecific and common in healthy individuals, especially the elderly. The review also covers interpretation of ANA patterns, when to order more specific antibodies (anti-dsDNA, anti-Sm), and briefly discusses antiphospholipid syndrome and ANCA testing for vasculitis.
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