ANA Multiplex with Reflex to 11 Antibody Cascade
Also known as: Multiplex Cascade, Progressive ANA
Use
This test provides a multiplex bead immunoassay–based screen for antinuclear antibodies (ANAs) targeting a panel of 11 specific autoantibodies. It is intended for use when ANA-specific diagnosis is warranted, particularly following a prior positive ANA screen by immunofluorescence assay (IFA), or when a tiered reflex approach to identifying autoantibody specificity is desired. A negative result does not rule out autoimmune disease, and clinical context should be considered.
Special Instructions
Reflex testing proceeds in a 3‑tier cascade: if the initial ANA multiplex screen is positive, testing proceeds through groups of antibodies in order—first tier (dsDNA, Sm/RNP, RNP, Sm, Chromatin); if all negative, second tier (SSA, SSB, Scl‑70, Jo‑1); if still negative, third tier (Ribosomal P, Centromere B). Each reflex incurs additional charge. Reflex stops upon the first positive result. For ANA IFA-negative patients, this test may be used for a tiered approach. Specimen and collection details not provided in adjacent content—refer to Quest requisition forms.
Limitations
The multiplex ANA screen tests only 11 specific autoantibodies and thus is less sensitive than ANA IFA, which screens for approximately 150 autoantibodies. A negative result does not rule out autoimmune disease, especially if the clinical suspicion remains high. The cascade will stop at the first positive antibody, potentially missing additional positives in later tiers. Prior positive ANA IFA result is recommended for context.
Methodology
Immunoassay (Multiplex Protein Panel)
Biomarkers
Result Turnaround Time
Not provided.
Related Documents
For more information, please review the documents below
Not provided.