Dr. Jennie Clarke discusses AntiNuclear Antibodies and answers common questions from her lecture on Saturday, November 11, 2023, at the 4th Annual Elevate-Derm PA/NP Conference in Coachella Valley, CA.
In this video
In this conversation with Derm PA Eileen Cheever, Dr. Jennie Clarke of the University of Utah describes ANAs as "like Pandora's box" — a positive result sets off a cascade of worry and testing, and knowing when, why, and how to order them is a real challenge. With hundreds of thousands of ANA tests ordered across the country by clinicians well beyond dermatology, she notes that many patients arrive convinced a positive result means autoimmune disease when it usually does not. She argues clinicians "can get away with ordering a lot fewer ANAs than we do."
Clarke's key reassurance: especially with low-titer results in the 1:40 to 1:80 range, up to a third of healthy people in the U.S. walk around with a positive ANA and no autoimmune disease. As she puts it, "the most common reason to have a positive ANA test is to be a normal, healthy person" — more common in women, though plenty of men test positive too. That single piece of education, she says, can give patients a lot of relief.
- Think carefully about when, why, and how to order an ANA — clinicians can likely order far fewer than they do.
- A positive ANA opens "Pandora's box" of downstream testing and patient anxiety, so it should be ordered with a clear purpose.
- Up to a third of healthy people carry a positive ANA, especially at low titers (1:40, 1:80), without any autoimmune disease.
- The most common reason for a positive ANA is simply being a normal, healthy person — more common in women, but seen in men too.
- Educating patients about low-titer positives can provide significant reassurance and reduce inappropriate follow-up testing.
