Positive ANA: What It Means and What to Do Next
A positive ANA (antinuclear antibody) test means your blood contains antibodies that react with the nucleus of your own cells. On its own it is not a diagnosis: about 1 in 7 people test positive, most of them healthy, especially at low titers such as 1:40 or 1:80. Higher titers (1:160 and above), certain patterns, and symptoms such as joint pain, rashes or mouth sores make an autoimmune disease like lupus, Sjögren's or scleroderma more likely. Because almost everyone with lupus has a positive ANA, a negative result makes lupus unlikely; a positive one needs follow-up tests and a clinician's exam to mean something.
What Causes High ANA?
No Disease at All
A low-titer positive ANA is common in healthy people, more so in women and with age. Many never develop an autoimmune disease.
Lupus (SLE)
Nearly everyone with systemic lupus erythematosus has a positive ANA. Anti-dsDNA antibodies and low complement levels (C3, C4) support the diagnosis.
Sjögren's Disease
An autoimmune disease of the tear and salivary glands that causes dry eyes and a dry mouth. Anti-SSA (Ro) and anti-SSB (La) antibodies are often present.
Systemic Sclerosis (Scleroderma)
Causes thickening of the skin and Raynaud's, with fingers that turn white or blue in the cold. Centromere and nucleolar ANA patterns point toward it.
Other Connective Tissue Diseases
Mixed connective tissue disease, inflammatory myositis and, less often, rheumatoid arthritis can all produce a positive ANA.
Autoimmune Thyroid or Liver Disease
Hashimoto's thyroiditis, Graves' disease and autoimmune hepatitis are common reasons for a positive ANA without lupus.
Medications
Some drugs can trigger a positive ANA and occasionally drug-induced lupus, including hydralazine, procainamide, isoniazid, minocycline and TNF inhibitors. It usually resolves after the drug is stopped under a prescriber's guidance.
Infections and Other Illnesses
Viral infections such as Epstein-Barr or hepatitis C, and some cancers, can make the ANA test positive, sometimes only for a while.
Associated Symptoms
What to Do Next
1. Go to the follow-up tests, not a repeat
A positive ANA rarely needs repeating: the titer does not track disease activity. The useful next step is the more specific antibody and complement tests below, reviewed with a clinician alongside your symptoms.
2. Related tests to consider
3. When to see a doctor
If your ANA is significantly abnormal, if you have severe symptoms, or if repeated results confirm the abnormality, consult a healthcare professional for appropriate evaluation and treatment.
Related Conditions
Frequently Asked Questions
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This page is for informational purposes only and does not constitute medical advice. Consult a healthcare provider for interpretation of your results.
Content reviewed for accuracy by the JustLabs editorial team.