ANA Comprehensive Test Panel | Analyzer ANA Test

About the test

This blood test (the ANAlyzer™) measures 25+ key markers that are related to autoimmune and immune-mediated inflammatory diseases, conditions that are caused by chronic inflammation in the body, and autoimmune activity. These include antinuclear antibodies (ANA), dsDNA antibody, Sm antibody, RNP antibody, Sm/RNP antibody, Jo-1 antibody, SS-A antibody, SS-B antibody, Scl-70 antibody, Centromere B antibody, chromatin antibody, C3/C4 complement components, rheumatoid factor (RF) antibodies, B2GP-1 antibodies, Cardiolipin antibodies, and TPO antibodies—markers that are commonly evaluated when autoimmune or arthritic conditions are suspected.

Chronic inflammation, as indicated by abnormal results on these tests, can appear in autoimmune and connective-tissue conditions such as rheumatoid arthritis (RA), lupus (systemic lupus erythematosus, SLE), psoriatic arthritis, antiphospholipid syndrome (APS), autoimmune thyroid disease, mixed connective tissue disease (MCTD), polymyositis, Sjögren's syndrome, and systemic sclerosis, as well as other inflammatory diseases. Some autoimmune diseases, such as rheumatoid arthritis, can worsen over time and can cause permanent, painful damage to tissues, organs, and joints if left untreated. Measuring these inflammation and autoimmune markers can help you and your healthcare provider better understand whether immune activity may be contributing to symptoms like muscle and joint pain, fatigue, or stiffness.

While more specific autoimmune testing is typically performed only after an initial positive antinuclear antibody (ANA) test result, this test panel performs all antibody testing regardless of the initial ANA result. This is beneficial because some specific markers of autoimmune disease can be positive even when there is a negative ANA test. Moreover, testing for all markers may help address comorbidities (diseases that may occur together), which are not uncommon in patients with autoimmune diseases.

This test can be useful if you are exploring persistent inflammation, assessing or reassessing your autoimmune status, or seeking clearer answers about unexplained joint or immune-related symptoms. Testing may be especially helpful if you have a family history, or you have new or ongoing symptoms. By getting tested, you and your healthcare provider can help understand the cause of your symptoms and identify next steps.

No doctor’s visit needed. Buy this ANA comprehensive panel online and visit a nearby Quest location.

This test may be right for you if any of the following are true:

You have a family history of
- Autoimmune inflammatory conditions such as rheumatoid arthritis (RA), lupus (systemic lupus erythematosus, SLE), psoriatic arthritis, antiphospholipid syndrome, autoimmune thyroid disease, mixed connective tissue disease (MCTD), polymyositis, Sjögren's syndrome, and systemic sclerosis
- Rheumatic or rheumatoid arthritis disease
You are experiencing signs and symptoms of inflammation, arthritis, and autoimmune diseases (see Signs and symptoms section below)
You have a previous positive/abnormal ANA result or other abnormal autoimmune labs and are looking for further insights

Please note: This test alone is not diagnostic of inflammatory conditions. It is important to follow up with your healthcare provider, who will review your results along with your medical history and signs and symptoms to determine next steps.

Quest offers four autoimmune testing options on questhealth.com depending on your needs:

Autoimmune Screening Test (ANA with Reflex), which provides an initial screen for ANA with a cascade of testing for other specific antibodies that will occur in groups if you have a positive ANA. Testing will stop at the first positive antibody
Rheumatoid Arthritis Test Panel, which measures markers more specifically associated with rheumatoid arthritis
Autoimmune & Inflammation Marker Test Panel, which includes the ANA Screen (with additional cascade testing upon positive result) and RA markers, as well as several other inflammatory markers
Comprehensive Autoimmune Evaluation Test Panel (this test), which provides results for all the following: antinuclear antibodies (ANA), dsDNA antibody, Sm antibody, RNP antibody, Sm/RNP antibody, Jo-1 antibody, SS-A antibody, SS-B antibody, Scl-70 antibody, Centromere B antibody, chromatin antibody, C3/C4 complement components, rheumatoid factor (RF) antibodies, B2GP-1 antibodies, Cardiolipin antibodies, and TPO antibodies. This is a good choice if there are specific antibodies that you want tested and you have previously had a negative ANA screen test result or you received a positive result and are interested in testing all markers instead of the first positive in a cascade

Quest’s ANAlyzer™ test is configured to be highly sensitive, allowing it to detect antibodies even at low levels. This matters because some people with autoimmune conditions don’t always show strong antibody levels. Higher levels of antibodies are more suggestive of autoimmune disease, while lower levels may require clinical context for diagnosis. In Quest's other autoimmune test panels, certain antibodies may only be tested if there is a positive result for ANA. Further, the additional antibodies are tested in a cascading fashion (in groups from most common to least common) and only the first positive result is reported back. In contrast, in this panel, you will receive results for an initial ANA screen and all the other antibodies included below. This panel is designed to give a healthcare provider further insights into the inflammatory condition(s) that a patient may be dealing with and is particularly useful when ANA antibody levels are low or multiple markers are positive.

Antinuclear antibodies are produced when the immune system mistakenly attacks the nucleus of its own cells instead of defending against outside invaders. A positive ANA is usually associated with systemic lupus erythematosus (SLE) but is also seen in many other autoimmune diseases, and may result in additional ANA tier and pattern testing.

Double stranded DNA (dsDNA) is part of the genetic material in our cells. dsDNA antibodies are produced when the immune system mistakenly attacks dsDNA. Antibodies to double-stranded DNA (dsDNA) are very specific for SLE. Their presence is associated with increased risk of lupus nephritis, and levels are useful for monitoring activity.²

Smith (Sm) antibodies are made when the immune system mistakenly attacks a protein component of small ribonucleoproteins. It is highly specific for SLE, although it is only detected in some patients.

RNP antibodies are made when the immune system mistakenly attacks the RNA portion of small ribonucleoproteins. These antibodies are present in some patients with SLE and are also highly associated with an overlap syndrome called mixed connective tissue disease (MCTD).

Sm/RNP antibodies are made when the immune system mistakenly attacks a unique target in small ribonucleoproteins, which include both Sm and RNP. It is present in a minority of patients with anti-Sm and/or anti-RNP, but its clinical significance is still being studied.

Jo-1 antibodies are made when the immune system mistakenly attacks a protein needed to build muscle cells. It is one of several myositis-specific antibodies associated with a particular type of myositis called anti-synthetase syndrome. This syndrome may include both skin and muscle pathology, as well as increased risk of chronic interstitial lung disease.

Sjögren antibodies are made when the immune system mistakenly attacks cells that produce moisture in your body, such as cells that make tears or saliva. This causes your body to feel very dry and tired. SS-A(Ro) antibodies are present in many patients with Sjögren syndrome and may also be present in some patients with SLE or RA. SS-B(La) antibodies are present in a smaller percentage of Sjögren syndrome patients.

Scleroderma antibodies are made when the immune system mistakenly tells the body to produce too much collagen, causing tissue to harden. Scl-70 antibody (also called anti-topoisomerase) is very specific for scleroderma.

The centromere is the part of a DNA chromosome that is important in cell division. Centromere antibodies are made when the immune system mistakenly attacks this portion of the body’s own chromosomes. These antibodies may be found in many scleroderma (progressive systemic sclerosis) patients and are associated with CREST (Calcinosis [calcium deposits], Raynaud's phenomenon [finger/toe color changes], Esophageal dysfunction [swallowing/reflux issues], Sclerodactyly [thickened finger skin], and Telangiectasias [spider veins]).

Chromatin is a DNA-protein complex in the nucleus that makes up individual chromosomes. Most patients with anti-dsDNA antibodies also have anti-chromatin antibodies and their presence may help a healthcare provider to confirm a diagnosis of SLE.

Complement refers to a series of proteins which are part of the inflammatory response. The two major components are C3 and C4. Low levels of these proteins may be found in severe acute inflammatory disorders, especially active SLE and cryoglobulinemic vasculitis.

Rheumatoid factor is a type of autoantibody that can attack and damage healthy tissue and is typically found in the blood of people who have rheumatoid arthritis. Because RF can be present in other conditions—and sometimes in healthy people—a positive result does not by itself confirm disease and should be interpreted alongside symptoms and other test results. The ANAlyzer panel includes testing for IgG, IgA, and IgM antibodies.

Cyclic citrullinated peptide is a type of autoantibody that can attack and damage healthy tissues, especially those in your joints, and is typically found in people who have rheumatoid arthritis. These antibodies are very specific for RA, although they are only found in half of patients.⁹ A positive result for anti-CCP also increases the risk of more severe disease.

Mutated citrullinated vimentin is a type of antibody typically found in people who have more severe or further progressed rheumatoid arthritis.

Beta-2-glycoprotein 1, also known as apolipoprotein H, is a substance that helps with normal blood clotting. Beta-2glycoprotein 1 antibodies are produced when the immune system mistakenly targets this substance, causing the body to clot incorrectly, increasing the risk of blood clots. Positive results for beta-2-glycoprotein 1 antibodies can help confirm the diagnosis of antiphospholipid antibody syndrome (APS). The ANAlyzeR panel includes testing for IgG, IgA, and IgM antibodies.

Cardiolipin is a fat in blood that helps with normal blood clotting. Cardiolipin antibodies are produced when the immune system mistakenly targets this fat, causing the body to clot too easily. Cardiolipin antibody testing can also detect the presence of beta-2-glycoprotein and other phospholipid bindings proteins. Positive results can help confirm the diagnosis of APS. The ANAlyzer™ panel includes testing for IgG, IgA, and IgM antibodies.

Thyroid peroxidase (TPO) is an enzyme involved in the production of thyroid hormones. TPO antibodies are produced when the immune system mistakenly targets the thyroid gland. Measuring TPO antibodies helps:

Identify autoimmune-related thyroid conditions
Support evaluation of conditions such as Hashimoto’s disease and certain forms of thyroiditis
Provide additional context when thyroid hormone levels are abnormal or borderline

Signs and symptoms of autoimmune diseases can vary from mild to severe, depending on the cause. Consider discussing your risk factors for autoimmune diseases with your healthcare provider if you’re experiencing one or more of the following:

Inflammation (redness, heat, swelling and pain) in one or more parts of your body
Ongoing fatigue or feeling unusually tired all the time
Swollen glands
Stiff, painful joints
Weak or achy muscles
Abdominal pain/digestive problems
Dry mouth and/or dry eyes
No appetite
Rashes, sores, dry/scaly skin
Fevers
Breathing troubles/shortness of breath

Signs and symptoms of RA can vary, especially since there are flare ups (when the signs and symptoms are worse) and times of remission (when the signs and symptoms are better). Consider discussing your risk factors for RA with your healthcare provider if you’re experiencing any of the following symptoms:

Tiredness
Joint aches and pains (especially in body parts on both sides of the body)
Joint stiffness (especially in body parts on both sides of the body)
Joint swelling and tenderness (especially in body parts on both sides of the body)
Fevers
Weakness

Purchaser: You must be 18 years of age or older to purchase a test on questhealth.com.

Patient: This test can be performed on patients between 18 and 100 years old.

Sample collection: This test requires specimen collection at a Quest Diagnostics location or through Quest Mobile® where available, a convenient option for in-home sample collection*. Collection not available in AZ or HI.

*Check your zip code here for service availability, not available in all locations. Quest Mobile is currently only available for individuals ages 18+.

No special preparation is required.

After you provide your specimen, it generally takes 7-10 business days to process and release your test results. However, processing times may vary. Your test results will be available in a clear and easy-to-read report. If you have or create a MyQuest® account, you may be able to review your new results there with your other Quest results. If your results differ from expected ranges, you may receive an alert call from an independent healthcare coordinator. Independent healthcare providers are available to discuss questions or concerns you may have regarding your results.

How it works

questhealth.com offers 150+ consumer-initiated Quest Diagnostics lab tests to empower you to have more control over your health journey. Choose from a variety of test types that best suit your needs.

In-person
In-home sample collection

1

Buy a lab test

No doctor visit is required for purchase, but an independent healthcare provider is involved throughout the process.

Shop now

2

Register your test
& schedule an appointment

Book a visit to one of 2000+ Quest locations.

Register your test

3

Visit Quest for sample collection

Complete your test sample collection during your scheduled appointment.

4

Get fast results

Access results online as soon as they’re available. You will be emailed when they are ready. Discuss your results with an independent healthcare provider at no extra cost. Treatment options may be available.

1

Buy a lab test
+ in-home sample collection

No doctor visit required for purchase. If in-home service is available in your area, purchase for an additional $79 fee.

Buy now

2

Register your test
& schedule an appointment

After you make a purchase, register your test and Quest Mobile will contact you to schedule an in-home sample collection appointment.

Register your test

3

In-home sample collection

A Quest Mobile phlebotomist will collect your sample and deliver it to Quest Diagnostics.

4

Get fast results

Access results online as soon as they’re available. You will be emailed when they are ready. Discuss your results with an independent healthcare provider at no extra cost. Treatment options may be available.

Please note: Quest Mobile is currently only available for individuals ages 18+.

Learn more about autoimmune diseases, triggers, and symptoms.

FAQs

What are antibodies and autoantibodies?

Antibodies are proteins in your blood that your body’s immune system makes when it meets something that is not supposed to be in your body, such as a virus or bacteria. This helps our body to fight off disease. Autoantibodies are also proteins in your blood, but they are made in response to our own body’s tissue. This causes our body to think of itself as a threat and tries to fight it, causing damage and keeping our body from working the right way.

Are there risk factors for RA to be aware of?

You may be more likely to develop RA if you have any of the following risk factors:

Sex – Females are two to three times more likely to develop RA
Age – Risk of developing RA increases with older age
Family History/Genetics – Being related to someone who has RA, and several genetic factors may increase the risk of developing RA
Obesity – Being obese increases risk of developing RA and treatment may not be as effective
Periodontitis – Diseased gums may cause an increased risk of developing RA
Smoking – Long periods of smoking increases risk of developing RA, and continued smoking can increase the effects of the disease
Lung Disease – Diseases of the lungs and airways may cause an increased risk of developing RA

Why choose this test over others? What is the difference between this Quest’s other autoimmune tests?

Most specific autoimmune testing is performed after an initial positive antinuclear antibody (ANA) test result, with additional markers being tested in a cascading fashion (in groups from most common to least common) and only the first positive result is reported back. Quest's other autoimmune test panels (Autoimmune Screening Test (ANA with Reflex) and Autoimmune & Inflammation Marker Test Panel) follow this model. With this panel, you will receive results for all 25+ markers listed above, regardless of your initial ANA result. Moreover, testing for all markers may help address comorbidities (diseases that may occur together), which are not uncommon in patients with autoimmune diseases. This is designed to give a healthcare provider further insights into the inflammatory condition(s) that a patient may be dealing with and is particularly useful when ANA antibody levels are low or multiple markers are positive. This is beneficial because some specific markers of autoimmune disease can be positive even when there is a negative ANA test.

I’ve heard that autoimmune conditions tend to occur together. Is this true?

Yes, patients with one autoimmune disease often have a higher risk of developing another autoimmune disease, including but not limited to type 1 diabetes, vitiligo, autoimmune gastritis, celiac disease, and Addison’s disease. You can find Quest’s range of autoimmune tests here.

Can I use my FSA or HSA funds to purchase tests on questhealth.com?

You may be able to use your FSA or HSA funds to purchase lab tests at questhealth.com. Please review your FSA/HSA plan or check with a tax professional to confirm specific requirements for individual eligibility.

Our references

1. National Institutes of Health News in Health. Understanding Autoimmune Diseases. Accessed October 30, 2025. https://newsinhealth.nih.gov/2022/06/understanding-autoimmune-diseases

2. NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases. Rheumatoid Arthritis. Accessed October 30, 2025. https://www.niams.nih.gov/health-topics/rheumatoid-arthritis

3. American College of Rheumatology. Rheumatoid Arthritis. Accessed October 30, 2025. https://rheumatology.org/patients/rheumatoid-arthritis

4. CDC Arthritis. Rheumatoid Arthritis. Accessed October 30, 2025. https://www.cdc.gov/arthritis/rheumatoid-arthritis/

5. Cleveland Clinic. Rheumatoid Factor. Accessed October 30, 2025. https://my.clevelandclinic.org/health/diagnostics/rheumatoid-factor

6. National Library of Medicine. MedlinePlus. CCP Antibody Test. Accessed October 30, 2025. https://medlineplus.gov/lab-tests/ccp-antibody-test/

7. Quest Diagnostics. Mutated Citrullinated Vimentin (MCV). Accessed February 3, 2026. https://testdirectory.questdiagnostics.com/test/test-detail/13238/mutated-citrullinated-vimentin-mcv-antibody?cc=MASTER

8. CDC Arthritis. Arthritis Basics. Accessed October 30, 2025. https://www.cdc.gov/arthritis/basics/index.html

9. Mayo Clinic. Scleroderma. Accessed February 3, 2026. https://www.mayoclinic.org/diseases-conditions/scleroderma/symptoms-causes/syc-20351952

10. Quest Diagnostics. ANAlyzer ANA, IFA with Reflex Titer/Pattern, Systemic Autoimmune Panel 1. Accessed February 3, 2026. https://testdirectory.questdiagnostics.com/test/test-guides/TS_ANAlyzeR_SystAutoPanel/analyzer-ana-ifa-with-reflex-titerpattern-systemic-autoimmune-panel-1?p=td

Tests purchased on questhealth.com are only for individuals who intend to pay directly for testing and do not want to submit a claim for reimbursement under their health insurance.

Comprehensive Autoimmune Evaluation Test Panel