Atypical Speckled Nuclear Antibody Test
This blood test detects unusual patterns of antinuclear antibodies (ANA) in your blood, helping doctors identify autoimmune conditions such as mixed connective tissue disease or lupus. A small blood sample from your arm is processed in a laboratory and examined under a fluorescence microscope for a distinctive speckled pattern. Your doctor will interpret the results together with your symptoms, physical examination, and other tests to decide whether further evaluation or treatment is needed.
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Key facts at a glance
- LOINC
- 53987-4
- Short code
- ATYP-SPECK-ANA-IFA
- Synonyms
- ANA atypic speckled Titr Ser IF
- Category
- cardiac
- Sample
- serum
- Container
- Serum separator tube (SST) or plain red top tube
- Units
- N/A
- Ref low
- 40
- Ref high
- 80
- Critical range
- — – 10000 N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- ≥ 18 years
- Method
- Indirect Immunofluorescence (IFA) on HEp-2 cells
- CPT
- 86038
- SNOMED
- 36673000
- Specimen volume
- 1.0-2.0 mL serum
- Stability
- Room temperature: 48 hours; Refrigerated (2-8°C): 7 days; Frozen (-20°C or below): 30 days
- Hemolysis max
- 50
- Lipemia max
- 300
- Icterus max
- 20
- TAT
- 48–168 hours
- Order
- routine
What is this test?
The atypical speckled nuclear antibody test is a specialized blood test that detects a specific pattern of antinuclear antibodies (ANA) in your blood. These antibodies are proteins that mistakenly target your own cell nuclei. The 'atypical speckled' pattern refers to how the antibodies appear under a fluorescence microscope after the blood sample is processed. This particular pattern is associated with certain autoimmune conditions, particularly mixed connective tissue disease, but can also be found in systemic lupus erythematosus (SLE) and other autoimmune disorders.
How is the test performed?
A healthcare professional will draw a small blood sample from a vein in your arm. The blood is then sent to a laboratory where it undergoes a process called indirect immunofluorescence. In this process, your blood serum is mixed with special cells on a slide. If antibodies are present, they will bind to the cell nuclei. A fluorescent dye is added, and the sample is examined under a microscope. The technician looks for the distinctive 'speckled' pattern of fluorescence, which indicates the presence of these specific antibodies.
What do the results mean?
Results are typically reported as a titer (a ratio indicating concentration) and a pattern. A positive result at a significant titer (usually 1:40 or higher, depending on the laboratory) indicates the presence of atypical speckled ANA. Your doctor will interpret this result in the context of your symptoms, physical examination, and other laboratory tests. A positive result does not automatically mean you have a disease—some healthy individuals may have low levels of these antibodies. Your healthcare provider will determine if further testing or treatment is needed based on your complete clinical picture.
Are there any risks or preparations needed?
This test requires only a standard blood draw, which carries minimal risks such as slight bruising or soreness at the injection site. No special fasting or preparation is typically required. You can resume normal activities immediately after the blood sample is collected. If you have a bleeding disorder or take blood thinners, inform your healthcare provider before the test.
Reference range
Negative at 1:40 dilution; Positive ≥1:80 dilutionN/A
No fasting required. Collect sample in standard manner. Inform laboratory of current medications, especially immunosuppressants or immunomodulatory drugs.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
The atypical speckled ANA pattern is clinically significant because it is often associated with mixed connective tissue disease (MCTD), a condition that shares features of several autoimmune diseases including lupus, scleroderma, and polymyositis. This pattern may also be seen in systemic lupus erythematosus (SLE), especially in patients with skin manifestations, and in other autoimmune conditions affecting the joints, muscles, and internal organs. The presence of this specific ANA pattern, combined with clinical symptoms and other laboratory findings, helps healthcare providers confirm a diagnosis and guide treatment decisions. Monitoring antibody levels over time may also help track disease activity or response to treatment.
Frequently asked questions
Why is this test ordered?
Do I need to fast before this test?
What does a positive result mean?
Can healthy people have a positive result?
How long does it take to get results?
Sources
- 1
- 2Mayo Clinic - ANA TestSource
- 3
Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 17, 2026. · Read our editorial policy