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Lab test

ANA Screen IFA with Reflex to Titer and Pattern

The ANA Screen, IFA measures antinuclear antibodies in a blood sample using immunofluorescence. A positive result reflexes automatically to titer and staining pattern reporting on the same sample.

Blood drawQuest patient service center

About this test

Antinuclear antibodies are measured using immunofluorescence assay (IFA) on HEp-2 cells, a method Quest describes as the gold standard for ANA testing because of its high sensitivity. This test is often used as part of an initial evaluation when there is clinical suspicion of an autoimmune disease associated with antinuclear antibodies, such as systemic lupus erythematosus, systemic sclerosis, mixed connective tissue disease, polymyositis, primary biliary cholangitis, rheumatoid arthritis, juvenile rheumatoid arthritis, Sjogren syndrome, or autoimmune hepatitis.

If the screen is positive, the sample is further characterized by antibody titer and by the fluorescent staining pattern seen in the nucleus or cytoplasm. Quest notes that a titer of at least 1:40 is considered positive, though low-positive titers are not uncommon in people without autoimmune disease, and that higher titers are generally associated with a greater likelihood of autoimmune disease.

Test details

Quest code249
MethodologyImmunofluorescence Assay
Sample type1 mL serum
CollectionQuest patient service center

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Additional details

What this test looks at

The test reports antinuclear antibodies in serum. A positive result reflexes to titer, which reports how dilute a sample can be and still show a positive reaction, and to pattern, which describes how the antibodies stain the nucleus or cytoplasm under fluorescence.

This test isn't orderable through the store yet. Requesting it tells us you want it and puts you on the list to be told when that changes — there is no charge and no commitment, and requesting does not place an order.

Laboratory results should always be interpreted by a licensed clinician who knows your health history. This page is information about a test, not medical advice.

Frequently asked questions

What does the ANA Screen, IFA measure?

It measures antinuclear antibodies in a serum sample using immunofluorescence assay on HEp-2 cells, described by Quest as the gold-standard method for ANA testing.

How is the sample collected?

The test uses a 1 mL serum sample from a routine blood draw.

Do I need to prepare for this test?

No preparation instructions are listed for this test, though people follow any instructions their ordering clinician provides.

What happens if my ANA screen is positive?

A positive screen automatically reflexes to titer and staining-pattern testing on the same sample, without a separate order.

Does a positive ANA mean I have an autoimmune disease?

Not on its own. Quest notes that low-positive titers are not uncommon in people without autoimmune disease, and that results are interpreted alongside clinical and family history and examination findings.

Last updated 2026-09-14 · How we write about lab testing

Educational content

This page is for general educational purposes only. It is not medical advice, and it is not a substitute for consultation with a qualified healthcare professional. Laboratory results should always be interpreted by a licensed clinician who knows your health history. Laboratory tests of this kind are used for screening and monitoring, not for diagnosis on their own — a diagnosis can only be made by a licensed clinician who evaluates results in the context of your health history and examination. If you have questions about your health or your results, talk with your doctor. If you think you may be experiencing a medical emergency, call 911.