Following a Record of Decision issued by the BC Ministry of Health, LifeLabs is changing the way Antinuclear antibodies (ANA) and Extractable nuclear antigens (ENA) are ordered and performed, starting August 8, 2021. The Record of Decision supports improved clinical utilization of this testing.
Previously, ANA and ENA could be ordered separately or together. Moving forward, ENA testing will not be conducted unless the patient has a positive ANA test within the previous 12 months.
Testing for ANA is the first step when screening for one of the systemic autoimmune rheumatic diseases (SARD). If the test is negative, the patient is highly unlikely to have one of the SARDs.
In patients with an ANA titer of 1:320 or higher, ENA testing will automatically be performed by LifeLabs as a reflex test.
When the titer for a positive ANA test is 1:80 or 1:160, ENA can still be ordered by a health care provider, but it will not be done automatically.
If ENA is ordered by itself and no ANA test has been performed in the past year, then an ANA test will be run on the patient specimen. The results of the ANA test will determine whether ENA testing is performed.